Optical coherence tomography in a patient with chloroquine-induced maculopathy

Indian J Ophthalmol. 2008 Nov-Dec;56(6):511-3. doi: 10.4103/0301-4738.43379.

Abstract

We herein report the optical coherence tomography (OCT) findings in a case of chloroquine-induced macular toxicity, which to our knowledge, has so far not been reported. A 53-year-old lady on chloroquine for treatment of rheumatoid arthritis developed decrease in vision 36 months after initiation of the treatment. Clinical examination revealed evidence of retinal pigment epithelial (RPE) disturbances. Humphrey field analyzer (HFA), fundus fluorescein angiography (FFA) and OCT for retinal thickness and volume measurements at the parafoveal region were done. The HFA revealed bilateral superior paracentral scotomas, FFA demonstrated RPE loss and OCT revealed anatomical evidence of loss of ganglion cell layers, causing marked thinning of the macula and parafoveal region. Parafoveal retinal thickness and volume measurements may be early evidence of chloroquine toxicity, and OCT measurements as a part of chloroquine toxicity screening may be useful in early detection of chloroquine maculopathy.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / drug therapy
  • Female
  • Fluorescein Angiography
  • Humans
  • Hydroxychloroquine / adverse effects*
  • Middle Aged
  • Retinal Diseases / chemically induced
  • Retinal Diseases / diagnosis*
  • Retinal Diseases / physiopathology
  • Retinal Ganglion Cells / drug effects
  • Retinal Ganglion Cells / pathology*
  • Retinal Pigment Epithelium / drug effects
  • Retinal Pigment Epithelium / pathology*
  • Scotoma / chemically induced
  • Scotoma / diagnosis*
  • Scotoma / physiopathology
  • Tomography, Optical Coherence
  • Visual Fields / physiology

Substances

  • Antirheumatic Agents
  • Hydroxychloroquine