LAUSR

OBJECTIVE To investigate the application of ultra-widefield fundus autofluorescence (UWF-FAF; Optos®) imaging in evaluating hydroxychloroquine (HCQ) retinopathy and to report peripheral autofluorescence findings in Asian patients with this condition. DESIGN Retrospective case series METHODS: SETTING: Institutional PATIENT POPULATION: Fifty-eight eyes of 29 patients with HCQ retinopathy. OBSERVATION PROCEDURES UWF-FAF imaging was performed using Optos 200 Tx (Optos PLC, Dunfermline, the United Kingdom), and the images were compared to conventional fundus autofluorescence (FAF) images obtained using a confocal digital ophthalmoscope (F-10; Nidek Co., Japan). The sensitivity of detecting retinopathy using the two modalities was compared. Peripheral autofluorescence findings in the eyes with HCQ retinopathy were assessed and their association with the Humphrey visual field test results obtained using the 30-2 and full-field 120 (FF-120) protocols was analyzed. MAIN OUTCOME MEASURES Abnormal FAF findings RESULTS: In 41 of 58 eyes (70.7%) with HCQ retinopathy, abnormal FAF findings were noted in the retinal periphery outside the field of view of conventional FAF as hypoautofluorescent (23 eyes, 39.7%) and hyperautofluorescent (38, 65.5%) lesions. In five eyes (8.6%), differences were revealed between conventional FAF and UWF-FAF in detecting retinopathy. Most of the eyes with severe retinopathy showed most extensive hypoautofluorescence in the nasal peripheral retina. The areas with abnormal FAF findings were significantly correlated with the number of unseen spots on FF120 results and mean deviation and pattern standard deviation of the 30-2 test results. (all P <.001) CONCLUSIONS: Peripheral autofluorescence findings varied in eyes with HCQ retinopathy according to the severity of the retinopathy. The retinal findings with UWF-FAF were functionally correlated to visual field results. UWF-FAF may be useful for evaluating HCQ retinopathy in Asian patients, particularly those with severe retinopathy.