Review of Retinal Imaging Modalities for Hydroxychloroquine Retinopathy

Diagnostics (Basel). 2023 May 16;13(10):1752. doi: 10.3390/diagnostics13101752.

Abstract

This review provides an overview of conventional and novel retinal imaging modalities for hydroxychloroquine (HCQ) retinopathy. HCQ retinopathy is a form of toxic retinopathy resulting from HCQ use for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Each imaging modality detects a different aspect of HCQ retinopathy and shows a unique complement of structural changes. Conventionally, spectral-domain optical coherence tomography (SD-OCT), which shows loss or attenuation of the outer retina and/or retinal pigment epithelium-Bruch's membrane complex, and fundus autofluorescence (FAF), which shows parafoveal or pericentral abnormalities, are used to assess HCQ retinopathy. Additionally, several variations of OCT (retinal and choroidal thickness measurements, choroidal vascularity index, widefield OCT, en face imaging, minimum intensity analysis, and artificial intelligence techniques) and FAF techniques (quantitative FAF, near-infrared FAF, fluorescence lifetime imaging ophthalmoscopy, and widefield FAF) have been applied to assess HCQ retinopathy. Other novel retinal imaging techniques that are being studied for early detection of HCQ retinopathy include OCT angiography, multicolour imaging, adaptive optics, and retromode imaging, although further testing is required for validation.

Keywords: HCQ retinopathy; adaptive optics; artificial intelligence; choroidal thickness; choroidal vascularity index; en face imaging; fluorescence lifetime imaging ophthalmoscopy; fundus autofluorescence; minimum intensity analysis; near-infrared fundus autofluorescence; novel; optical coherence tomography; optical coherence tomography angiography; quantitative; retinal imaging; retinal thickness; retromode imaging; toxicity; widefield imaging.

Publication types

  • Review

Grants and funding

This research received no external funding.