학술논문

Extreme Interocular Asymmetry in an Atypical Case of a Hydroxychloroquine-Related Retinopathy
Document Type
article
Source
Medicina, Vol 58, Iss 7, p 967 (2022)
Subject
hydroxychloroquine
hydroxychloroquine toxicity screening
bull’s eye maculopathy
parafoveal retinal hydroxychloroquine toxicity
pericentral retinal hydroxychloroquine toxicity
Medicine (General)
R5-920
Language
English
ISSN
1648-9144
1010-660X
Abstract
Background and Objectives: Long-term hydroxychloroquine (HCQ) therapy can lead to retinal toxicity. Typically, it is characterized by a bull’s eye maculopathy. More recently, a “pericentral” form of HCQ retinopathy that predominantly affects patients of Asian descent has been described. To our knowledge, this is the first reported case where such an asymmetry between the right and the left eye in the toxicity profile is observed. Case presentation: The patient presented with a 12-year exposure to HCQ at a daily dose of 4.35 mg/kg. She presented an inferior pericentral-only phenotype of HCQ toxicity on the right eye and a perifoveal-only toxicity on the left eye. Modest progression of toxicity was observed on both eyes over the seven years of follow-up, despite drug discontinuation. Conclusions: To our knowledge, this is the first time that two different phenotypes of HCQ-related retinopathy are found in the same patient, challenging our understanding of the pathophysiology of HCQ retinal toxicity.