Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy
<i>Background and Objectives</i>: Long-term hydroxychloroquine (HCQ) therapy can lead to retinal toxicity. Typically, it is characterized by a bull’s eye maculopathy. More recently, a “pericentral” form of HCQ retinopathy that predominantly affects patients of Asian descent has been desc...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/7/967 |
| _version_ | 1797445317556174848 |
|---|---|
| author | Gabriel Hallali Zari Seyed Anne-Véronique Maillard Karima Drine Laurence Lamour Céline Faure Isabelle Audo |
| author_facet | Gabriel Hallali Zari Seyed Anne-Véronique Maillard Karima Drine Laurence Lamour Céline Faure Isabelle Audo |
| author_sort | Gabriel Hallali |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Long-term hydroxychloroquine (HCQ) therapy can lead to retinal toxicity. Typically, it is characterized by a bull’s eye maculopathy. More recently, a “pericentral” form of HCQ retinopathy that predominantly affects patients of Asian descent has been described. To our knowledge, this is the first reported case where such an asymmetry between the right and the left eye in the toxicity profile is observed. <i>Case presentation</i>: The patient presented with a 12-year exposure to HCQ at a daily dose of 4.35 mg/kg. She presented an inferior pericentral-only phenotype of HCQ toxicity on the right eye and a perifoveal-only toxicity on the left eye. Modest progression of toxicity was observed on both eyes over the seven years of follow-up, despite drug discontinuation. <i>Conclusions</i>: To our knowledge, this is the first time that two different phenotypes of HCQ-related retinopathy are found in the same patient, challenging our understanding of the pathophysiology of HCQ retinal toxicity. |
| first_indexed | 2024-03-09T13:24:02Z |
| format | Article |
| id | doaj.art-1b6a46aa291e4c1886e74cc0c7188b8c |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T13:24:02Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-1b6a46aa291e4c1886e74cc0c7188b8c2023-11-30T21:25:38ZengMDPI AGMedicina1010-660X1648-91442022-07-0158796710.3390/medicina58070967Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related RetinopathyGabriel Hallali0Zari Seyed1Anne-Véronique Maillard2Karima Drine3Laurence Lamour4Céline Faure5Isabelle Audo6Ophthalmic Pediatric Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceElectrophysiology Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceElectrophysiology Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceElectrophysiology Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceElectrophysiology Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceElectrophysiology Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, FranceOphthalmic Pediatric Unit, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, France<i>Background and Objectives</i>: Long-term hydroxychloroquine (HCQ) therapy can lead to retinal toxicity. Typically, it is characterized by a bull’s eye maculopathy. More recently, a “pericentral” form of HCQ retinopathy that predominantly affects patients of Asian descent has been described. To our knowledge, this is the first reported case where such an asymmetry between the right and the left eye in the toxicity profile is observed. <i>Case presentation</i>: The patient presented with a 12-year exposure to HCQ at a daily dose of 4.35 mg/kg. She presented an inferior pericentral-only phenotype of HCQ toxicity on the right eye and a perifoveal-only toxicity on the left eye. Modest progression of toxicity was observed on both eyes over the seven years of follow-up, despite drug discontinuation. <i>Conclusions</i>: To our knowledge, this is the first time that two different phenotypes of HCQ-related retinopathy are found in the same patient, challenging our understanding of the pathophysiology of HCQ retinal toxicity.https://www.mdpi.com/1648-9144/58/7/967hydroxychloroquinehydroxychloroquine toxicity screeningbull’s eye maculopathyparafoveal retinal hydroxychloroquine toxicitypericentral retinal hydroxychloroquine toxicity |
| spellingShingle | Gabriel Hallali Zari Seyed Anne-Véronique Maillard Karima Drine Laurence Lamour Céline Faure Isabelle Audo Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy Medicina hydroxychloroquine hydroxychloroquine toxicity screening bull’s eye maculopathy parafoveal retinal hydroxychloroquine toxicity pericentral retinal hydroxychloroquine toxicity |
| title | Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy |
| title_full | Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy |
| title_fullStr | Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy |
| title_full_unstemmed | Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy |
| title_short | Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy |
| title_sort | extreme interocular asymmetry in an atypical case of a hydroxychloroquine related retinopathy |
| topic | hydroxychloroquine hydroxychloroquine toxicity screening bull’s eye maculopathy parafoveal retinal hydroxychloroquine toxicity pericentral retinal hydroxychloroquine toxicity |
| url | https://www.mdpi.com/1648-9144/58/7/967 |
| work_keys_str_mv | AT gabrielhallali extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT zariseyed extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT anneveroniquemaillard extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT karimadrine extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT laurencelamour extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT celinefaure extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy AT isabelleaudo extremeinterocularasymmetryinanatypicalcaseofahydroxychloroquinerelatedretinopathy |