Macular ganglion cell–inner plexiform layer thickness for detection of early retinal toxicity of hydroxychloroquine

Kan, Emrah; Yakar, Konuralp; Demirağ, Mehmet Derya; Gök, Mustafa

doi:10.1007/s10792-017-0635-y

Cited by 24 publications

(23 citation statements)

References 26 publications

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“…However, in vitro studies suggested that the accumulation of HCQ was located in the outer retina or the choroidal tissue. Thus, our results might solve the previous discrepancies of some studies that found GCL thinning in HCQ retinopathy [11] and others that did not find any significant change in this layer [10]. On the other hand, our findings support that the first damaged retinal layer might be the ONL, as we discovered a significant thinning in patients with early HCQ retinopathy compared with control eyes in different retinal sectors, especially in the nasal area, as well as a significant correlation of ONL thickness and the duration of HCQ treatment.…”

Section: Discussionsupporting

confidence: 74%

“…Retinal layer segmentation allows us to analyze the ganglion cell layer (GCL) together with the inner plexiform layer (IPL) with Cirrus OCT, which is referred to as GCIPL in the literature. 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].…”

Section: Introductionsupporting

confidence: 61%

“…However, one of its main side effects is HCQ retinopathy. This finding was first described in 1959 in patients that used chloroquine [3], and since then, HCQ retinopathy has been well documented in several papers [4][5][6][7][8][9][10][11][12][13][14][15], as early detection of it and drug discontinuation prevents the patient from developing established visual symptoms [13][14][15]. It is important to point out that the discontinuation of hydroxychloroquine does not prevent further macular deterioration.…”

Section: Discussionmentioning

confidence: 92%

“…Similarly, in patients with temporal VF defect, nasal ONL thinning was significant compared with temporal, superior, or inferior ONL values (p < 0.001). 1,5,9,10,11,13, and 14 (p = 0.046, p = 0.017, p = 0.014, p = 0.003, p = 0.047, p = 0.015, p = 0.024, and p = 0.046, respectively). No sector of GCL was correlated with the duration of HCQ treatment (p > 0.211).…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 74%

Section: Introductionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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“…Finally yet importantly, structural retinal changes are not unique to preclinical or clinical AD. Similar changes may occur in other disease, such as hydroxychloroquine retinal toxicity [47] and glaucoma [48]. Exactly, we conducted the study according to rigorously exclusion criteria, which excluded individuals with retina-related disease, such as glaucoma, age-related macular degeneration, diabetic retinopathy and pathological myopia.…”

Section: Discussionmentioning

confidence: 99%

Ganglion Cell-Inner Plexiform Layer Thickness is Associated with Persistently Cognitive Decline -The Rugao Longevity and Aging Study

Zhang

Shen

Xiao-yan

et al. 2020

Preprint

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Background: The simple, convenient and well-validated biomarkers are imperative for detection of cognitive decline (CD). The powerful evidence is lacked for verifying the reliability and clinical utility of retinal biomarkers for detection of CD with repeated assessments. To investigate the association of retinal thickness with CD using repeated assessments. Methods: This study included 446 older adults with three-time repeated assessments of cognitive function during 5-years follow-up. Retinal thickness measured on spectral-domain optical coherence tomography. Logistic regression models were conducted to analyze the association of retinal thickness with cognitive function. Results: According to cognitive status in three assessments, individuals were categorized into consistently normal cognition groups (N = 159), persistently CD groups (N = 134), progressed to CD groups (N = 70), and reverting or fluctuating CD groups (N = 83). Thinner ganglion cell-inner plexiform layer (GC-IPL) was associated with persistently CD (odds ratio [OR] per 1-μm decrease: 1.09, 95% confidence interval [CI], 1.02-1.18; per standard deviation [SD] decrease: 1.78, 95%CI, 1.04-3.19) rather than progressed to CD, reverting or fluctuating CD. No significant relationship was found between retinal nerve fiber layer and any CD subgroups (p > 0.05). Conclusions: Thinner GC-IPL was associated with persistently CD, suggesting retinal neurodegeneration may be a promising biomarker for persistently CD. Further studies, including both longitudinal and repeated measurements of retinal layer thickness and cognitive function, are needed to assess the possibility of retinal thickness as a biomarker for persistent CD.

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Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

2020

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Purpose To detect the early changes in retinal vasculature via optical coherence tomography angiography (OCTA) by comparing the quantitative OCTA parameters in the group of patients who were using hydroxychloroquine (HCQ) or not. Methods This was a cross-sectional, comparative, and observational study. The patients who were newly or previously prescribed HCQ for an autoimmune disease were included. OCTA imaging was performed via OCT RT XR Avanti with AngioVue software (Optivue Inc, Freemont, CA). The study group had two groups: a control group (patients newly diagnosed and who were not taking any medication) and a treatment group (patients who were receiving HCQ treatment). The main outcome measure was OCTA parameters. Results A total of 102 eyes of 102 patients were included. There were 70 patients in the treatment group and 32 patients in the control group. All of the vascular density values were similar between the control and treatment groups (p [ 0.05 for all). However, the superficial whole thickness, superficial parafoveal thickness, superficial perifoveal thickness, deep whole thickness, deep parafoveal thickness, and deep perifoveal thickness were thinner in the treatment group than the control group (p \ 0.05 for all). Conclusion Vascular density parameters did not differ between the control and treatment groups. However, the retinal thickness values were lower in the treatment group.

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Macular ganglion cell–inner plexiform layer thickness for detection of early retinal toxicity of hydroxychloroquine

Cited by 24 publications

References 26 publications

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

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

Ganglion Cell-Inner Plexiform Layer Thickness is Associated with Persistently Cognitive Decline -The Rugao Longevity and Aging Study

Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

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