Choroidal Thinning Associated With Hydroxychloroquine Retinopathy

Ahn, Seong Joon; Ryu, So Jung; Joung, Joo Young; Lee, Byung Ro

doi:10.1016/j.ajo.2017.08.022

Cited by 44 publications

(46 citation statements)

References 30 publications

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“…Pasadhika and Fishman [19] also showed that a selective thinning of the inner retina can be quantified in the absence of any changes clinically visible in the fundus. Like almost all studies on the topic of hydroxychloroquine retinopathy [7, 15, 20-22], we are not able to draw any definite conclusion regarding the sequence of events associated with the disease, due to the retrospective cross-sectional design. However, our results also emphasize that the effects of long-term hydroxychloroquine are not limited to the outer retina.…”

Section: Discussioncontrasting

confidence: 69%

“…Both chloroquine and hydroxychloroquine have been shown to interfere in the visual cycle by inhibiting the uptake activity of the organic anion-transporting polypeptide 1A2 (OATP1A2) expressed in human RPE cells [14]. More recently, the choroid was involved in the pathophysiology, with progressive thinning of the choriocapillaris associated with increasing cumulative doses [15]. …”

Section: Discussionmentioning

confidence: 99%

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Structural and Functional Characterization of the Retinal Effects of Hydroxychloroquine Treatment in Healthy Eyes

et al. 2019

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Purpose: To evaluate the influence of hydroxychloroquine in visual field and retinal layer thickness. Methods: This is a retrospective cross-sectional study. Patients taking hydroxychloroquine without signs of hydroxychloroquine retinopathy were included. Optical coherence tomography segmentation was used to obtain the ETDRS map thickness of each retinal layer. Groups were divided into short-term (< 5 years) and long-term (≥5 years) drug use. Results: We included 93 eyes of 93 patients (short-term: 25 eyes; long-term: 68 eyes). The inner nuclear layer (INL) was thinner in the long-term group (32.86 ± 2.12 vs. 34.14 ± 2.37 μm; p = 0.014). Considering long-term cases, the parafoveal ganglion cell layer (GCL) showed an inverse correlation with cumulative dose (r = –0.37; p < 0.001). After adjusting for confounders, parafoveal ganglion cell complex thickness was associated with cumulative dose (β = –0.239; p = 0.011). The parafoveal outer retina and visual field indices were similar between groups and did not correlate with cumulative dose. Conclusion: Hydroxychloroquine leads to progressive thinning of the parafoveal inner retina, particularly the INL and GCL. Visual field indices do not reflect the long-term effects of the drug.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Structural and Functional Characterization of the Retinal Effects of Hydroxychloroquine Treatment in Healthy Eyes

et al. 2019

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“…Although the first results of this analysis showed no relationship between the thinning of GCIPL and HCQ retinopathy [10], recent results have led other researchers to hypothesize that GCIPL thinning could be an early indicator of it in screening use [11]. However, recent studies have located HCQ damage in the outer retina or the choroidal tissue, which is close to the findings of in vitro studies [12][13][14][15]. Some of these studies assessed the retina using OCT angiography.…”

Section: Introductionsupporting

confidence: 56%

“…Some of these studies assessed the retina using OCT angiography. This device allowed them to obtain en face images that could be analyzed by two investigators in a masked manner [13,15]. However, OCT segmentation could depict objective values of thickness of retinal layers.…”

Section: Introductionmentioning

confidence: 99%

Outer Nuclear Layer Damage for Detection of Early Retinal Toxicity of Hydroxychloroquine

et al. 2020

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In hydroxychloroquine (HCQ) retinopathy, early detection of asymptomatic retinal changes and the interruption of the drug are essential to prevent permanent vision loss. Our purpose was to investigate the roles of ganglion cell layer (GCL) and outer nuclear layer (ONL) thicknesses measured by optical coherence tomography (OCT) in the early diagnosis of retinopathy. One hundred and fourteen eyes of 76 individuals with HCQ treatment were enrolled in the study (42 eyes with impaired visual field (VF) and 72 eyes with nondamaged VF). We found that ONL was significantly decreased in the HCQ retinopathy group compared with the control group in the nasal macula (p = 0.032) as well as in four sectors (p < 0.044), whereas no significant differences were found comparing GCL in both groups. If VF were altered superiorly or temporarily, ONL was significantly thinned inferiorly (p = 0.029) and nasally (p = 0.008), respectively. Duration of HCQ treatment was significantly related with ONL in seven sectors of ONL (p < 0.047). We suggest that ONL measured with OCT might be used to assess early HCQ retinal toxicity.

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“…There were 5430 patients in the hydroxychloroquine-use group (1260 men, 4170 women) with a mean AE SD age of 50Á5 AE 14Á8 years, and 21 720 patients in the nonuse group (5040 men, 16 680 women), with a mean AE SD age of 50Á0 AE 15Á1 years. The mean AE SD follow-up period was 6Á30 AE 3Á65 years in the hydroxychloroquine-use group and 6Á41 AE 3Á66 years in the nonuse group (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. At the end of the follow-up period, patients in the hydroxychloroquine-use group had a higher incidence of retinopathy than those in the nonuse group [5Á38 vs. 4Á27 per 1000 person-years; incidence rate ratio (IRR) 1Á26, 95% confidence interval (CI) 1Á16-1Á36] ( Table 1).…”

mentioning

confidence: 99%

Real‐world database examining the association between hydroxychloroquine and retinopathy in Taiwan

2018

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Choroidal Thinning Associated With Hydroxychloroquine Retinopathy

Cited by 44 publications

References 30 publications

Structural and Functional Characterization of the Retinal Effects of Hydroxychloroquine Treatment in Healthy Eyes

Structural and Functional Characterization of the Retinal Effects of Hydroxychloroquine Treatment in Healthy Eyes

Outer Nuclear Layer Damage for Detection of Early Retinal Toxicity of Hydroxychloroquine

Real‐world database examining the association between hydroxychloroquine and retinopathy in Taiwan

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