Lydia Sauer1, Charles M Calvo1, Alexandra S Vitale1, Nicholas Henrie1, Cole M Milliken2, Paul S Bernstein3. 1. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. 2. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah; Medical University of South Carolina, Charleston, South Carolina. 3. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. Electronic address: paul.bernstein@hsc.utah.edu.
Abstract
PURPOSE: To investigate the impact of retinal toxicity from hydroxychloroquine (HCQ) on fundus autofluorescence lifetimes using fluorescence lifetime imaging ophthalmoscopy (FLIO). DESIGN: Cross-sectional study. PARTICIPANTS: Twenty-four eyes of 12 patients with definite HCQ toxicity, 31 eyes of 16 clinically normal patients at high risk of developing HCQ toxicity (taking HCQ longer than 5 years), and 16 eyes of 8 clinically normal patients at low risk of developing HCQ toxicity (taking HCQ fewer than 5 years), as well as 22 age-matched healthy subjects. METHODS: Fluorescence lifetime images of a 30° retinal field centered at the fovea were collected at the Moran Eye Center, Salt Lake City, Utah. A prototype Heidelberg Engineering Spectralis-based FLIO was used to detect autofluorescence lifetimes in short (SSC; 498-560 nm) and long (LSC; 560-720 nm) spectral channels. Mean fluorescence lifetimes were calculated. OCT scans and macular pigment measures were also recorded. Additionally, the autofluorescence lifetimes of HCQ were measured in a cuvette. MAIN OUTCOME MEASURES: Mean autofluorescence lifetimes (τm). RESULTS: All patients with HCQ toxicity showed significantly prolonged FLIO lifetimes in regions of damage, typically in a bulls-eye distribution corresponding to toxic lesions in the retina (SSC: lesion, 400 ps; unremarkable retina, 294 ps; P < 0.001; LSC: lesion, 404 ps; unremarkable retina, 316 ps; P < 0.001). Some clinically normal patients at high risk (9 of 16) and at low risk (2 of 8) of developing HCQ toxicity also showed prolonged FLIO lifetimes in the parafoveal region, whereas age-matched healthy subjects did not. HCQ at a concentration of 46 mM exhibited long autofluorescence lifetimes of around 1100 ps in either spectral channel. CONCLUSIONS: Fluorescence lifetime imaging ophthalmoscopy seems to detect retinal toxicity from HCQ at very early stages and could be a novel method to detect retinal toxicity before irreversible damage is manifest.
PURPOSE: To investigate the impact of retinal toxicity from hydroxychloroquine (HCQ) on fundus autofluorescence lifetimes using fluorescence lifetime imaging ophthalmoscopy (FLIO). DESIGN: Cross-sectional study. PARTICIPANTS: Twenty-four eyes of 12 patients with definite HCQtoxicity, 31 eyes of 16 clinically normal patients at high risk of developing HCQtoxicity (taking HCQ longer than 5 years), and 16 eyes of 8 clinically normal patients at low risk of developing HCQtoxicity (taking HCQ fewer than 5 years), as well as 22 age-matched healthy subjects. METHODS: Fluorescence lifetime images of a 30° retinal field centered at the fovea were collected at the Moran Eye Center, Salt Lake City, Utah. A prototype Heidelberg Engineering Spectralis-based FLIO was used to detect autofluorescence lifetimes in short (SSC; 498-560 nm) and long (LSC; 560-720 nm) spectral channels. Mean fluorescence lifetimes were calculated. OCT scans and macular pigment measures were also recorded. Additionally, the autofluorescence lifetimes of HCQ were measured in a cuvette. MAIN OUTCOME MEASURES: Mean autofluorescence lifetimes (τm). RESULTS: All patients with HCQtoxicity showed significantly prolonged FLIO lifetimes in regions of damage, typically in a bulls-eye distribution corresponding to toxic lesions in the retina (SSC: lesion, 400 ps; unremarkable retina, 294 ps; P < 0.001; LSC: lesion, 404 ps; unremarkable retina, 316 ps; P < 0.001). Some clinically normal patients at high risk (9 of 16) and at low risk (2 of 8) of developing HCQtoxicity also showed prolonged FLIO lifetimes in the parafoveal region, whereas age-matched healthy subjects did not. HCQ at a concentration of 46 mM exhibited long autofluorescence lifetimes of around 1100 ps in either spectral channel. CONCLUSIONS: Fluorescence lifetime imaging ophthalmoscopy seems to detect retinal toxicity from HCQ at very early stages and could be a novel method to detect retinal toxicity before irreversible damage is manifest.
Authors: Alexandra S Vitale; Lydia Sauer; Natalie K Modersitzki; Paul S Bernstein Journal: Transl Vis Sci Technol Date: 2020-09-30 Impact factor: 3.283
Authors: Lydia Sauer; Alexandra S Vitale; Cole M Milliken; Natalie K Modersitzki; J David Blount; Paul S Bernstein Journal: Transl Vis Sci Technol Date: 2020-08-03 Impact factor: 3.283
Authors: Clara Reichel; Andreas Berlin; Victoria Radun; Ioana-Sandra Tarau; Jost Hillenkamp; Nikolai Kleefeldt; Kenneth R Sloan; Thomas Ach Journal: Transl Vis Sci Technol Date: 2020-08-28 Impact factor: 3.283