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Julio A. Rodriguez-Padilla, MD; Thomas R. Hedges III, MD; Bryan Monson, BS; Vivek Srinivasan, MS; Maciej Wojtkowski, PhD; Elias Reichel, MD; Jay S. Duker, MD; Joel S. Schuman, MD; James G. Fujimoto, PhD

Arch Ophthalmol. 2007;125(6):775-780.

Objectives  To compare structural changes in the retina seen on high-speed ultra–high-resolution optical coherence tomography (hsUHR-OCT) with multifocal electroretinography (mfERG) and automated visual fields in patients receiving hydroxychloroquine.

Methods  Fifteen patients receiving hydroxychloroquine were evaluated clinically with hsUHR-OCT, mfERG, and automated visual fields. Six age-matched subjects were imaged with hsUHR-OCT and served as controls.

Results  Distinctive discontinuity of the perifoveal photoreceptor inner segment/outer segment junction and thinning of the outer nuclear layer were seen with hsUHR-OCT in patients with mild retinal toxic effects. Progression to complete loss of the inner segment/outer segment junction and hyperscattering at the outer segment level were seen in more advanced cases. The mfERG abnormalities correlated with the hsUHR-OCT findings. Asymptomatic patients had normal hsUHR-OCT and mfERG results.

Conclusion  Distinctive abnormalities in the perifoveal photoreceptor inner segment/outer segment junction were seen on hsUHR-OCT in patients receiving hydroxychloroquine who also were symptomatic and had abnormalities on automated visual fields and mfERG.

Author Affiliations: New England Eye Center, Tufts–New England Medical Center, Tufts University, Boston, Mass (Drs Rodriguez-Padilla, Hedges, Reichel, and Duker and Mr Monson); Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge (Mr Srinivasan and Drs Wojtkowski and Fujimoto); Institute of Physics, Nicolaus Copernicus University, Torun, Poland (Dr Wojtkowski); and Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pa (Dr Schuman).

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