Mimickers of hydroxychloroquine retinal toxicity

Clin Exp Ophthalmol. 2024 Dec;52(9):1003-1015. doi: 10.1111/ceo.14461. Epub 2024 Dec 3.

Abstract

Hydroxychloroquine (HCQ) retinal toxicity is an important entity that can be challenging to differentiate from its mimickers. Bull's eye maculopathy is the classical presentation of HCQ retinopathy; however, its differential includes several drug-related retinal toxicities, inherited retinal disorders, and systemic conditions with associated retinopathies. Given the similarities in clinical presentation, imaging findings, and other diagnostic data, it can be quite challenging for all but the retina specialists to successfully identify retinal toxicity from HCQ. This review summarises HCQ retinopathy and its mimickers of with a special emphasis on key clinical and ancillary distinctions that can help comprehensive ophthalmologists and primary care offices in clenching this diagnosis.

Keywords: bulls eye maculopathy; hydroxychloroquine retinal toxicity; hydroxychloroquine retinopathy mimickers; inherited retinal degenerations; plaquenil toxicity.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents* / adverse effects
  • Antirheumatic Agents* / toxicity
  • Diagnosis, Differential
  • Fluorescein Angiography / methods
  • Humans
  • Hydroxychloroquine* / adverse effects
  • Retina / diagnostic imaging
  • Retina / drug effects
  • Retina / pathology
  • Retinal Diseases* / chemically induced
  • Retinal Diseases* / diagnosis
  • Tomography, Optical Coherence / methods

Substances

  • Hydroxychloroquine
  • Antirheumatic Agents