Hydroxychloroquine Retinopathy with SD-OCT Changes and Minimal Fundus Changes
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The images shown here refer to the same case as "Hydroxychloroquine Retinopathy with Minimal Fundus Changes". This 68 year old woman with systemic lupus erythematosus had been on hydroxychloroquine at a dosage of 400 mg/d (6.52 mg/kg/d) for eight years. Her optometrist had checked her yearly during that time until in the eighth year he became suspicious of hydroxychloroquine toxicity because of visual field changes noted. E - Spectral domain optical coherence tomography shows loss of the inner segment/ outer segment junction (orange arrow) compared to the more normal structure retained at the yellow arrow, and reduction in thickness of the outer nuclear layer (blue arrow). SD-OCT is an objective test for toxicity that complements 10-2 visual field testing. 10-2 visual testing is probably more sensitive, but is heir to interpretational difficulties and variability not so much a problem with SD-OCT.