Use of En Face Optical Coherence Tomography in a Case of Hydroxychloroquine Retinal Toxicity

To describe the case of 49-year-old woman with a history of rheumatoid arthritis on hydroxychloroquine (HCQ) therapy, who presented with findings of HCQ retinopathy on optical coherence tomography (OCT). Evaluation included clinical examination with multimodal imaging findings on spectral domain (SD)-OCT, en face OCT, and multifocal electroretinogram (mfERG). The patient had nonspecific visual symptoms and an unremarkable funduscopic examination. Humphrey visual fields, fundus autofluorescence, mfERG, SD-OCT, and en face structural OCT, however, suggested HCQ retinal toxicity. This case demonstrates that the findings of HCQ retinopathy on en face structural OCT are analogous to those identified by current imaging modalities used for the screening and diagnosis of HCQ toxicity. En face structural OCT may be useful in the detection of HCQ-induced retinal toxicity