Application of optical coherence tomography angiography for microvascular changes in patients treated with hydroxychloroquine: a systematic review and meta-analysis

Ferreira, André; Anjos, Rita; Vieira, Rafael José; Afonso, Miguel; Abreu, Ana Carolina; Monteiro, Sílvia; Macedo, Mafalda; Andrade, José Paulo; Furtado, Maria João; Lume, Miguel

doi:10.1007/s00417-023-06023-2

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…In contrast to our results, previous studies have postulated a significant effect of HCQ intake on retinal VD in patients with various underlying diseases [36]. However, the results of these studies do not allow conclusions to be drawn as to whether the measured VD reduction actually results from HCQ therapy or the underlying disease.…”

Section: Discussioncontrasting

confidence: 99%

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Microvascular Density Analysis of Patients with Inactive Systemic Lupus Erythematosus—A Two-Year Follow-Up Optical Coherence Tomography Angiography Study

Leclaire,

Esser,

Dierse

et al. 2024

JCM

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Background/Objectives: This study aims to investigate the long-term effect of inactive systemic lupus erythematosus (SLE) on the retinal microcirculation measured via optical coherence tomography angiography (OCT-A). Methods: Twenty-four eyes of 24 patients with inactive SLE under hydroxychloroquine (HCQ) therapy were included. The OCT-A data (mainly vessel density (VD) and foveal avascular zone (FAZ) data of the superficial and of the deep capillary plexus (SCP, DCP) and the choriocapillaris (CC)) were analyzed and compared between the baseline examination (t0) and 2 years later (t1). Results: At t1, VD in the whole en face SCP and in the CC was notably reduced compared to t0 (SCP: p = 0.001, CC: p = 0.013). VD in the DCP, CRT and FAZ area showed no difference at t1 compared to t0 (DCP: p = 0.128, FAZ: p = 0.332, CRT fovea: p = 0.296). Correlation analysis between the increase in cumulative doses of HCQ between t0 and t1 and the VD of the whole en face SCP did not show any correlation (Spearman r = 0.062 (95% CI −0.367; 0.477). Conclusions: SLE patients demonstrated a decrease in the retinal VD of the SCP and CC over a 2-year period. There was no correlation with the change in cumulative doses of HCQ. These results suggest an ongoing effect of the disease on the retinal and choriocapillary microcirculation.

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Section: Discussioncontrasting

confidence: 99%

“…In a recent meta-analysis, Ferreira et al examined the effect of HCQ therapy on retinal perfusion [36]. In this analysis, it is postulated that HCQ therapy is associated with a significantly decreased retinal VD.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Density Analysis of Patients with Inactive Systemic Lupus Erythematosus—A Two-Year Follow-Up Optical Coherence Tomography Angiography Study

Leclaire,

Esser,

Dierse

et al. 2024

JCM

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“…HCQ treatment can cause microvascular damage in these diseases. [31][32][33] In a recent meta-analysis, Ferreira et al 33 found patients with HCQ treatment, particularly those with a long treatment period, have a lower VD. Furthermore, HCQ treatment was also found to reduce retinal microvasculature in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Microvasculature alterations of peripapillary retina and macula in systemic lupus erythematosus patients without ocular involvement by optical coherence tomography angiography

Li,

Yu,

et al. 2023

Retina

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Purpose: To evaluate microvasculature alterations of the peripapillary retina (PR) and macula and to assess if the changes can detect preclinical retinopathy in systemic lupus erythematosus (SLE) patients. Methods: Cross-sectional study of 32 SLE patients without retinopathy and 22 normal controls. Optical coherence tomography angiography was used to measure the microvasculature of the PR and macula. Vessel densities (VD, %) and fractal dimensions of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated. Results: Compared to controls, macular VD of the whole image SCP (mVD of SCP-wi) and mVD of inferior SCP (mVD of SCP-i) were significantly reduced in SLE patients (p<0.05). The peripapillary VD (pVD) of a 2.5mm circle of SCP (pVD of SCPΦ2.5), pVD of SCPΦ3.5, and pVD of inferior region of the inner circle of SCP (pVD of SCP-ii) were significantly reduced in patients treated with hydroxychloroquine (HCQ) >5 years. mVD of SCP-wi declined with age (β=-0.12; p<0.01) and pVD of SCP-ii declined with hydroxychloroquine cumulative dose (β=-0.01; p<0.01). mVD of SCP-i had the best discrimination power of 0.77 (p<0.01). Conclusion: SLE patients without ocular involvement had microvasculature alterations that were particularly evident in the SCP. PR microvasculature may be reduced in patients with longer HCQ treatment.

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Impact of cumulative dose of hydroxychloroquine on retinal structures

Montesel,

Sacconi,

La Rubia

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Application of optical coherence tomography angiography for microvascular changes in patients treated with hydroxychloroquine: a systematic review and meta-analysis

Cited by 6 publications

References 32 publications

Microvascular Density Analysis of Patients with Inactive Systemic Lupus Erythematosus—A Two-Year Follow-Up Optical Coherence Tomography Angiography Study

Microvascular Density Analysis of Patients with Inactive Systemic Lupus Erythematosus—A Two-Year Follow-Up Optical Coherence Tomography Angiography Study

Microvasculature alterations of peripapillary retina and macula in systemic lupus erythematosus patients without ocular involvement by optical coherence tomography angiography

Impact of cumulative dose of hydroxychloroquine on retinal structures

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