Hydroxychloroquine retinopathy combined with retinal pigment epithelium detachment

Abstract

Purpose: To describe a case of hydroxychloroquine retinopathy combined with retinal pigment epithelium (RPE) detachment and evaluate possible causes of pigment epithelium detachment. Methods: Single case report and literature review. Results: A 44-year-old lady presented with "decreasing visual acuity and field since a few months ago". She was diagnosed with systemic lupus erythematosus and had been on hydroxychloroquine 400 mg orally twice daily for 10 years. Fluorescein angiography and fundus autofluorescence revealed the decrease in RPE amount or function in the right eye. Spectral domain optical coherence tomography revealed preservation of central foveal outer retinal structure surrounded by perifoveal outer retinal thinning in the right eye. Adjacent to fovea, between fovea and disc, large sized RPE detachment was seen. Conclusion: We herein report the first case of hydroxychloroquine retinopathy combined with RPE detachment. RPE dysfunction caused by long-term use of hydroxychloroquine can be manifested as pigment epithelium detachment.