Wide-field OCT protocols offer better sensitivity for detecting HCQ retinopathy among Asians

Investigators have found that standard OCT protocols may be inadequate for detecting hydroxychloroquine (HCQ) retinopathy in some Asian patients.

Study design

This was a prospective study on 48 eyes of 24 Asian patients with HCQ retinopathy. Participants underwent imaging with spectral domain OCT (6 mm line and 6×6-mm² volume scans) and swept-source OCT (9-mm line scans, 6×6-mm² and 12x9-mm² volume scans).

Outcomes

Approximately one-third of eyes had photoreceptor defects that were greater than 3 mm away from the fovea. These peripheral lesions were not covered by standard OCT scans, and were seen only on wide-field line or volume scans.

The 9-mm line scans showed significantly better sensitivity than 6-mm scans in detecting HCQ retinopathy (P<0.001). Wide volume scan also showed greater sensitivity over standard volume scans (P=0.001).

Limitations

This study was limited by a relatively small sample size with varying degrees of retinopathy severity. The cohort included only Korean patients and it is possible that distribution of HCQ retinopathy is different between Koreans and other Asian patients.

Clinical significance

This study showed a pericentral distribution of retinopathy among patients of Korean descent. These may be missed by standard OCT protocols using 6-mm line scans or 6×6-mm volume scans. As such, the authors recommend wide-field OCT protocols for screening in Asian patients taking HCQ.