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Near-infrared reflectance bull’s eye maculopathy as an early indication of hydroxychloroquine toxicity

Authors Wong K, Pautler S, Browning D

Received 4 November 2014

Accepted for publication 27 January 2015

Published 19 March 2015 Volume 2015:9 Pages 521—525


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Keye L Wong,1 Scott E Pautler,2 David J Browning3

1Retina Associates of Sarasota, Sarasota, FL, USA; 2Retina Vitreous Associates of Florida, Tampa, FL, USA; 3Charlotte Eye Ear Nose and Throat Associates, Charlotte, NC, USA

Importance: In some patients, hydroxychloroquine ocular toxicity may progress even following cessation of therapy. Any leverage the clinician may use to allow earlier detection may avert significant vision loss.
Observation: We report three cases suggesting that bull’s eye maculopathy seen on near-infrared reflectance with a confocal scanning laser ophthalmoscope could be an early, objective manifestation of hydroxychloroquine ocular toxicity, and with progression of the disease this near-infrared “bull’s eye” change may disappear.
Conclusion and relevance: Alerting clinicians to this observation may allow a larger case series to corroborate the hypothesis that bull’s eye maculopathy detected by near-infrared reflectance may represent an early sign of hydroxychloroquine toxicity.

Keywords: confocal, scanning laser ophthalmoscope, multifocal ERG

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