Perifoveal interdigitation zone loss in hydroxychloroquine toxicity leads to subclinical bull’s eye lesion appearance on near-infrared reflectance imaging
Purpose To characterize the ultrastructural and functional correlates of hydroxychloroquine (HCQ)-induced subclinical bull’s eye lesion seen on near-infrared reflectance (NIR) imaging. Methods An asymptomatic 54-year-old male taking HCQ presented with paracentral ring-like scotoma, abnormal multifocal electroretinography (mfERG) and preserved ellipsoid zone on optical coherence tomography (OCT). Dense raster OCT was performed to create en face reflectivity maps of the interdigitation zone. Macular Integrity Assessment (MAIA) microperimetry and mfERG findings were compared with NIR imaging, en face OCT, retinal thickness profiles and wave-guiding cone density maps derived from flood-illumination adaptive optics (AO) retinal photography. Results The bull’s eye lesion is an oval annular zone of increased reflectivity on NIR with an outer diameter of 1450 µm. This region corresponds exactly to an area of preserved interdigitation zone reflectivity in en face OCT images and of normal cone density on AO imaging. Immediately surrounding the bull’s eye lesion is an annular zone (3°–12° eccentricity) of depressed retinal sensitivity on MAIA and reduced amplitude density on mfERG. Wave-guiding cone density at 2° temporal was 25,400 per $ mm^{2} $. This declined rapidly to 12,900 and 1200 per $ mm^{2} $ at 3° and 4°. Conclusion Multimodal imaging illustrated pathology in the area surrounding the NIR bull’s eye, characterized by reduced reflectance, wave-guiding cone density and retinal function. Further studies are required to investigate whether the bull’s eye on NIR imaging and en face OCT is prominent or consistent enough for diagnostic use..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2017 |
|---|---|
| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:136 |
|---|---|
| Enthalten in: |
Documenta ophthalmologica - 136(2017), 1 vom: 09. Nov., Seite 57-68 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chew, Avenell L. [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
Adaptive optics |
|---|
| RVK: |
|---|
| Anmerkungen: |
© The Author(s) 2017 |
|---|
| doi: |
10.1007/s10633-017-9615-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2112963384 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2112963384 | ||
| 003 | DE-627 | ||
| 005 | 20230503042018.0 | ||
| 007 | tu | ||
| 008 | 230503s2017 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10633-017-9615-9 |2 doi | |
| 035 | |a (DE-627)OLC2112963384 | ||
| 035 | |a (DE-He213)s10633-017-9615-9-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 050 |q VZ |
| 082 | 0 | 4 | |a 610 |q VZ |
| 084 | |a XA 40800 |q VZ |2 rvk | ||
| 100 | 1 | |a Chew, Avenell L. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Perifoveal interdigitation zone loss in hydroxychloroquine toxicity leads to subclinical bull’s eye lesion appearance on near-infrared reflectance imaging |
| 264 | 1 | |c 2017 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © The Author(s) 2017 | ||
| 520 | |a Purpose To characterize the ultrastructural and functional correlates of hydroxychloroquine (HCQ)-induced subclinical bull’s eye lesion seen on near-infrared reflectance (NIR) imaging. Methods An asymptomatic 54-year-old male taking HCQ presented with paracentral ring-like scotoma, abnormal multifocal electroretinography (mfERG) and preserved ellipsoid zone on optical coherence tomography (OCT). Dense raster OCT was performed to create en face reflectivity maps of the interdigitation zone. Macular Integrity Assessment (MAIA) microperimetry and mfERG findings were compared with NIR imaging, en face OCT, retinal thickness profiles and wave-guiding cone density maps derived from flood-illumination adaptive optics (AO) retinal photography. Results The bull’s eye lesion is an oval annular zone of increased reflectivity on NIR with an outer diameter of 1450 µm. This region corresponds exactly to an area of preserved interdigitation zone reflectivity in en face OCT images and of normal cone density on AO imaging. Immediately surrounding the bull’s eye lesion is an annular zone (3°–12° eccentricity) of depressed retinal sensitivity on MAIA and reduced amplitude density on mfERG. Wave-guiding cone density at 2° temporal was 25,400 per $ mm^{2} $. This declined rapidly to 12,900 and 1200 per $ mm^{2} $ at 3° and 4°. Conclusion Multimodal imaging illustrated pathology in the area surrounding the NIR bull’s eye, characterized by reduced reflectance, wave-guiding cone density and retinal function. Further studies are required to investigate whether the bull’s eye on NIR imaging and en face OCT is prominent or consistent enough for diagnostic use. | ||
| 650 | 4 | |a Fundus autofluorescence | |
| 650 | 4 | |a Bull’s eye maculopathy | |
| 650 | 4 | |a Adaptive optics | |
| 650 | 4 | |a optical coherence tomography | |
| 650 | 4 | |a Multifocal electroretinography | |
| 650 | 4 | |a Microperimetry | |
| 700 | 1 | |a Sampson, Danuta M. |4 aut | |
| 700 | 1 | |a Chelva, Enid |4 aut | |
| 700 | 1 | |a Khan, Jane C. |4 aut | |
| 700 | 1 | |a Chen, Fred K. |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Documenta ophthalmologica |d Springer Berlin Heidelberg, 1938 |g 136(2017), 1 vom: 09. Nov., Seite 57-68 |w (DE-627)129521493 |w (DE-600)212594-8 |w (DE-576)014936674 |x 0012-4486 |7 nnns |
| 773 | 1 | 8 | |g volume:136 |g year:2017 |g number:1 |g day:09 |g month:11 |g pages:57-68 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s10633-017-9615-9 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a GBV_ILN_2018 | ||
| 912 | |a GBV_ILN_4012 | ||
| 912 | |a GBV_ILN_4112 | ||
| 912 | |a GBV_ILN_4219 | ||
| 936 | r | v | |a XA 40800 |
| 951 | |a AR | ||
| 952 | |d 136 |j 2017 |e 1 |b 09 |c 11 |h 57-68 | ||