Hydroxychloroquine treatment alters retinal layers and choroid without apparent toxicity in optical coherence tomography

Polat, Osman Ahmet; Okçu, Mehmet; Yılmaz, Mevlüt

doi:10.1016/j.pdpdt.2022.102806

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…Studies have shown a dosage-dependent atrophy of inner retinal layers and the retina pigment epithelium due to hydroxychloroquine [ 34 ] while others did not find any layer differences [ 7 , 11 ]. By applying OCTA, a small cohort study found retinal vessel atrophy in some sectors of the deep vascular complex and in the superior sector of the superficial complex in pSS patients under hydroxychloroquine treatment [ 35 ] while others could not find any differences [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography angiography suggests different retinal pathologies in multiple sclerosis and Sjögren’s syndrome

Wolf,

Wicklein,

Aly

et al. 2024

J Neurol

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Background While retinal vessel changes are evident in the eyes of patients with relapsing–remitting multiple sclerosis (RRMS), changes in the vasculature of possible MS mimics such as primary Sjögren’s syndrome (pSS) remain to be determined. We investigated the potential of retinal optical coherence tomography (OCT) angiography (OCTA) as diagnostic tool to differentiate between patients with RRMS and pSS. Methods This cross-sectional study included patients with RRMS (n = 36), pSS (n = 36) and healthy controls (n = 30). Participants underwent clinical examination, assessment of visual acuity, retinal OCT, OCTA, and serum markers of glial and neuronal damage. We investigated the associations between OCTA parameters, visual functions, and serum markers. Eyes with a history of optic neuritis (ON) were excluded from analysis. Results We observed a significant thinning of the combined ganglion cell and inner plexiform layer in the eyes of patients with RRMS but not with pSS, when compared to healthy controls. Retinal vessel densities of the superficial vascular complex (SVC) were reduced in both patients with RRMS and pSS. However, retinal vessel rarefication of the deep vascular complex (DVC) was only evident in patients with pSS but not RRMS. Using multivariate regression analysis, we found that DVC vessel loss in pSS patients was associated with worse visual acuity. Conclusions Compared to patients with RRMS, rarefication of deep retinal vessels is a unique characteristic of pSS and associated with worse visual function. Assuming a disease-specific retinal vessel pathology, these data are indicative of a differential affliction of the gliovascular complex in the retina of RRMS and pSS patients.

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Section: Discussionmentioning

confidence: 99%

Optical coherence tomography angiography suggests different retinal pathologies in multiple sclerosis and Sjögren’s syndrome

Wolf,

Wicklein,

Aly

et al. 2024

J Neurol

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“…Polat et al, in a separate study of 49 patients, reported that subfoveal CT values were significantly reduced in patients who had used HCQ for fewer than five years (p = 0.042) and in patients who had used HCQ for five years or longer (p = 0.009) compared with the controls [69]. Parafoveally, CT was also reduced in the temporal sector, though not in the nasal sector, in patients who had used HCQ for five years or longer compared with the controls (p = 0.018) [69]. In a study of 47 patients, Halouani et al also reported that the subfoveal and the mean CT were decreased in the advanced toxicity group compared with healthy controls (p < 0.001) [83].…”

Section: Choroidal Changesmentioning

confidence: 94%

“…Group I also demonstrated significant thinning of the inner, outer, and full-thickness retina (p < 0.001) and Group II had significant thinning only of the inner retina (p < 0.001) compared with Group III [68]. Polat et al, in another study of 49 patients, reported that inferior and nasal parafoveal RNFL, and temporal parafoveal GCL and IPL thicknesses were thinner, while the temporal parafoveal RPE was thicker in HCQ users [69].…”

Section: Novel Retinal Imaging For Hcq Retinopathymentioning

confidence: 96%

Review of Retinal Imaging Modalities for Hydroxychloroquine Retinopathy

et al. 2023

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This review provides an overview of conventional and novel retinal imaging modalities for hydroxychloroquine (HCQ) retinopathy. HCQ retinopathy is a form of toxic retinopathy resulting from HCQ use for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Each imaging modality detects a different aspect of HCQ retinopathy and shows a unique complement of structural changes. Conventionally, spectral-domain optical coherence tomography (SD-OCT), which shows loss or attenuation of the outer retina and/or retinal pigment epithelium–Bruch’s membrane complex, and fundus autofluorescence (FAF), which shows parafoveal or pericentral abnormalities, are used to assess HCQ retinopathy. Additionally, several variations of OCT (retinal and choroidal thickness measurements, choroidal vascularity index, widefield OCT, en face imaging, minimum intensity analysis, and artificial intelligence techniques) and FAF techniques (quantitative FAF, near-infrared FAF, fluorescence lifetime imaging ophthalmoscopy, and widefield FAF) have been applied to assess HCQ retinopathy. Other novel retinal imaging techniques that are being studied for early detection of HCQ retinopathy include OCT angiography, multicolour imaging, adaptive optics, and retromode imaging, although further testing is required for validation.

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Automated analysis of choroidal thickness in patients with systemic lupus erithematosus treated with hydroxychloroquine

Arias-Peso,

Chacón González,

García-Navarro

et al. 2024

Int Ophthalmol

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Hydroxychloroquine treatment alters retinal layers and choroid without apparent toxicity in optical coherence tomography

Cited by 7 publications

References 28 publications

Optical coherence tomography angiography suggests different retinal pathologies in multiple sclerosis and Sjögren’s syndrome

Optical coherence tomography angiography suggests different retinal pathologies in multiple sclerosis and Sjögren’s syndrome

Review of Retinal Imaging Modalities for Hydroxychloroquine Retinopathy

Automated analysis of choroidal thickness in patients with systemic lupus erithematosus treated with hydroxychloroquine

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