Adaptive optics cone arrangement in hydroxychloroquine users without signs of retinal toxicity based on current screening guidelines: a case-control study.

Purpose: To describe early cone changes detected by adaptive optics (AO) in patients on chronic hydroxychloroquine (HC) treatment with no abnormalities on standard functional or structural retinal tests.

Methods: Case-control study including 36 eyes of 36 female patients. Cases included 18 women on HC for autoimmune disease whose cumulative dose exceeded 1600 g and who demonstrated no evidence of retinal toxicity on visual field (VF), spectral domain optical coherence tomography (SD-OCT), or multifocal electroretinography (mfERG).