Cargando…

Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity

Hydroxychloroquine (HCQ) ocular toxicity is rare but severe, and progression can occur even after termination of therapy. Case reports have suggested that a bull’s eye maculopathy detected by near-infrared reflectance (NIR) may indicate early HCQ toxicity. This retrospective cross-sectional study ev...

Descripción completa

Detalles Bibliográficos
Autores principales: Santos, Miguel, Leal, Inês, Morais Sarmento, Tiago, Mano, Sofia Sousa, José, Patrícia, Vaz-Pereira, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913952/
https://www.ncbi.nlm.nih.gov/pubmed/36766550
http://dx.doi.org/10.3390/diagnostics13030445
_version_ 1784885550046511104
author Santos, Miguel
Leal, Inês
Morais Sarmento, Tiago
Mano, Sofia Sousa
José, Patrícia
Vaz-Pereira, Sara
author_facet Santos, Miguel
Leal, Inês
Morais Sarmento, Tiago
Mano, Sofia Sousa
José, Patrícia
Vaz-Pereira, Sara
author_sort Santos, Miguel
collection PubMed
description Hydroxychloroquine (HCQ) ocular toxicity is rare but severe, and progression can occur even after termination of therapy. Case reports have suggested that a bull’s eye maculopathy detected by near-infrared reflectance (NIR) may indicate early HCQ toxicity. This retrospective cross-sectional study evaluated patients treated with HCQ who underwent routine screening with optical coherence tomography (OCT), fundus autofluorescence (FAF) and 10-2 perimetry. NIR images captured alongside OCT were subsequently graded independently by 2 masked graders for the presence of bull’s eye maculopathy, and the result was compared to the outcome of the screening. A total of 123 participants (246 eyes) were included, and 101 (90%) were female. The patients’ mean age was 55.2 ± 13.8 years. The mean time of HCQ usage was 84.0 ± 72.3 months, and the mean weekly dose was 2327 ± 650 mg. Two eyes showed toxicity in all 3 routine screening exams, with one patient suspending HCQ. The prevalence of bull´s eye lesions in NIR was 13% (33 eyes) with substantial intergrader agreement, a 71.3% specificity and 88.0% negative predictive value for HCQ toxicity. We suggest that NIR changes may be a sign of early HCQ toxicity. The detection of NIR bull´s eye lesions may warrant an increased screening frequency.
format Online
Article
Text
id pubmed-9913952
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99139522023-02-11 Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity Santos, Miguel Leal, Inês Morais Sarmento, Tiago Mano, Sofia Sousa José, Patrícia Vaz-Pereira, Sara Diagnostics (Basel) Article Hydroxychloroquine (HCQ) ocular toxicity is rare but severe, and progression can occur even after termination of therapy. Case reports have suggested that a bull’s eye maculopathy detected by near-infrared reflectance (NIR) may indicate early HCQ toxicity. This retrospective cross-sectional study evaluated patients treated with HCQ who underwent routine screening with optical coherence tomography (OCT), fundus autofluorescence (FAF) and 10-2 perimetry. NIR images captured alongside OCT were subsequently graded independently by 2 masked graders for the presence of bull’s eye maculopathy, and the result was compared to the outcome of the screening. A total of 123 participants (246 eyes) were included, and 101 (90%) were female. The patients’ mean age was 55.2 ± 13.8 years. The mean time of HCQ usage was 84.0 ± 72.3 months, and the mean weekly dose was 2327 ± 650 mg. Two eyes showed toxicity in all 3 routine screening exams, with one patient suspending HCQ. The prevalence of bull´s eye lesions in NIR was 13% (33 eyes) with substantial intergrader agreement, a 71.3% specificity and 88.0% negative predictive value for HCQ toxicity. We suggest that NIR changes may be a sign of early HCQ toxicity. The detection of NIR bull´s eye lesions may warrant an increased screening frequency. MDPI 2023-01-26 /pmc/articles/PMC9913952/ /pubmed/36766550 http://dx.doi.org/10.3390/diagnostics13030445 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Santos, Miguel
Leal, Inês
Morais Sarmento, Tiago
Mano, Sofia Sousa
José, Patrícia
Vaz-Pereira, Sara
Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title_full Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title_fullStr Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title_full_unstemmed Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title_short Bull’s Eye Maculopathy in Near-Infrared Reflectance as An Early Sign of Hydroxychloroquine Toxicity
title_sort bull’s eye maculopathy in near-infrared reflectance as an early sign of hydroxychloroquine toxicity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913952/
https://www.ncbi.nlm.nih.gov/pubmed/36766550
http://dx.doi.org/10.3390/diagnostics13030445
work_keys_str_mv AT santosmiguel bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity
AT lealines bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity
AT moraissarmentotiago bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity
AT manosofiasousa bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity
AT josepatricia bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity
AT vazpereirasara bullseyemaculopathyinnearinfraredreflectanceasanearlysignofhydroxychloroquinetoxicity