Fundus autofluorescence and spectral domain optical coherence tomography in early detection of Plaquenil maculopathy.

PURPOSE: To report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT) findings in a patient with early hydroxychloroquine maculopathy.

METHODS

A 50-year-old man presented with complaints of ring-like shadows in front of his eyes. He had been on hydroxychloroquine (Plaquenil) 400 mg orally twice daily for 10 years (5.14 mg/kg/day). Fundus examination revealed granular hypopigmentation in an arcuate pattern in the inferior parafoveal area bilaterally. The patient underwent further evaluation with SD-OCT and FAF imaging. Functional changes were assessed by microperimetry.

RESULTS

Hypopigmented lesions on the fundus were autofluorescent and SD-OCT corresponding to this area revealed loss of inner segment-outer segment, suggesting loss of photoreceptor layer in the affected area with underling dysfunctional retinal pigment epithelium.

CONCLUSIONS

Findings on SD-OCT and FAF imaging support the histopathologic findings described in cases of hydroxychloroquine maculopathy.