Objective: To evaluate foveal structural changes by spectral domain optical coherence tomography (Sd-OCT) in patients receiving antimalarials.

Materials and Methods: The study was designed as an observational case-control study. Twenty eight patients receiving chloroquine (CQ) or hydroxychloroquine (HCQ) were evaluated clinically using Sd-OCT and automated visual fields. Twenty age-matched subjects serving as controls were imaged with Sd-OCT.

Results: The mean age of the patients was 34.2 years (ranged from 22 to 40 years). All patients were female. The control subjects were included twenty females (mean age: 31.4; ranged from 19 to 42 years). Eighteen patients receiving anti-malarial drugs had mild retina pigment epithelium (RPE) changes and perifoveal cupping detected by Sd-OCT without visual field defect. In the rest of patients in and the controls, perifoveal retinal thicknesses as well as central foveal thicknesses did not show any significant difference. These cases had not perifoveal cupping and visual field defect. The mean central foveal thicknesses in the patients with perifoveal cupping and without perifoveal cupping were 219.57±20.12 μm and 222.42±24.02 μm, respectively. The mean central foveal thickness, as determined by OCT, was 221.13±25.44 (range 201–248 μm) in the patients and 218.96±22.02 μm (range 189–239 μm) in controls. The difference between the groups was not statistically significant (p=0.7).

Conclusion: Perifoveal cupping, in the other words, perifoveal retinal thinning may be a predictor for impending antimalarial related maculopathy.