Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity

Purpose: To report an unusual fundus autofluorescence aspect in a patient with suspected hydroxychloroquine retinal toxicity. Method: Case report of an unusual presentation of a patient treated for 9 consecutive years with a therapeutically recommended dose of hydroxychloroquine. Result: We report t...

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Main Author: Sleiman Abou-Ltaif
Format: Article
Language:English
Published: Karger Publishers 2015-06-01
Series:Case Reports in Ophthalmology
Subjects:
Online Access:http://www.karger.com/Article/FullText/433417
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author Sleiman Abou-Ltaif
author_facet Sleiman Abou-Ltaif
author_sort Sleiman Abou-Ltaif
collection DOAJ
description Purpose: To report an unusual fundus autofluorescence aspect in a patient with suspected hydroxychloroquine retinal toxicity. Method: Case report of an unusual presentation of a patient treated for 9 consecutive years with a therapeutically recommended dose of hydroxychloroquine. Result: We report the case of a 53-year-old Caucasian female treated with 400 mg hydroxychloroquine for rheumatoid arthritis over 9 years, currently on methotrexate and folinic acid, who stopped treatment 3 years ago. The cumulative dose is estimated at 1.314 kg. She recently noticed a reduction of vision in both eyes to 0.34 logMAR, with colour vision problems and major distortion in central vision. Fundus autofluorescence revealed minimal foveal pigmentary changes and more pronounced changes in the retina elsewhere. Foveal changes were confirmed by optical coherence tomography in both eyes. The patient did not report any colour perception difficulties or night vision problems and has no family history of any eye condition. Her visual field tested by an optician was full, with some central changes. Conclusion: Retinal toxicity from hydroxychloroquine can present in a different aspect than the commonly known retinal toxicity, and it happens even after years of cessation of the drug. The role of cumulative dose in toxicity is supported in this paper.
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spelling doaj.art-ed50c7c2711d483f82b07c8600600e622022-12-22T01:41:08ZengKarger PublishersCase Reports in Ophthalmology1663-26992015-06-016218619010.1159/000433417433417Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal ToxicitySleiman Abou-LtaifPurpose: To report an unusual fundus autofluorescence aspect in a patient with suspected hydroxychloroquine retinal toxicity. Method: Case report of an unusual presentation of a patient treated for 9 consecutive years with a therapeutically recommended dose of hydroxychloroquine. Result: We report the case of a 53-year-old Caucasian female treated with 400 mg hydroxychloroquine for rheumatoid arthritis over 9 years, currently on methotrexate and folinic acid, who stopped treatment 3 years ago. The cumulative dose is estimated at 1.314 kg. She recently noticed a reduction of vision in both eyes to 0.34 logMAR, with colour vision problems and major distortion in central vision. Fundus autofluorescence revealed minimal foveal pigmentary changes and more pronounced changes in the retina elsewhere. Foveal changes were confirmed by optical coherence tomography in both eyes. The patient did not report any colour perception difficulties or night vision problems and has no family history of any eye condition. Her visual field tested by an optician was full, with some central changes. Conclusion: Retinal toxicity from hydroxychloroquine can present in a different aspect than the commonly known retinal toxicity, and it happens even after years of cessation of the drug. The role of cumulative dose in toxicity is supported in this paper.http://www.karger.com/Article/FullText/433417ToxicityAutofluorescenceHydroxychloroquine
spellingShingle Sleiman Abou-Ltaif
Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
Case Reports in Ophthalmology
Toxicity
Autofluorescence
Hydroxychloroquine
title Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
title_full Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
title_fullStr Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
title_full_unstemmed Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
title_short Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity
title_sort unusual fundus autofluorescence appearance in a patient with hydroxychloroquine retinal toxicity
topic Toxicity
Autofluorescence
Hydroxychloroquine
url http://www.karger.com/Article/FullText/433417
work_keys_str_mv AT sleimanaboultaif unusualfundusautofluorescenceappearanceinapatientwithhydroxychloroquineretinaltoxicity