September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Analyse by adaptative optics of peri foveolar photoreceptors’ density during screening of Hydroxychloroquine induce maculopathy
Author Affiliations & Notes
  • Fanny Babeau
    Ophthalmology, Gui de Chauliac Hospital, Prades Le Lez, France
  • Timothé Busetto
    Ophthalmology, Gui de Chauliac Hospital, Prades Le Lez, France
  • Max Villain
    Ophthalmology, Gui de Chauliac Hospital, Prades Le Lez, France
  • Vincent Daien
    Ophthalmology, Gui de Chauliac Hospital, Prades Le Lez, France
  • Footnotes
    Commercial Relationships   Fanny Babeau, None; Timothé Busetto, None; Max Villain, None; Vincent Daien, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5102. doi:
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      Fanny Babeau, Timothé Busetto, Max Villain, Vincent Daien; Analyse by adaptative optics of peri foveolar photoreceptors’ density during screening of Hydroxychloroquine induce maculopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5102.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Ophthalmic screening is mandatory for early detection of toxic maculopathy in patients treated with Hydroxychloroquine (HCQ). Adaptive optics (AO) imaging allows direct visualization of the photoreceptor mosaic. The purpose of this study is to explore the performance of AO in early detection of toxic hydroxychloroquine maculopathy.

Methods : 39 patients treated with HCQ, 11 patients with an auto-immune disease without HCQ therapy and 16 controls were enrolled prospectively at university hospital of Montpellier from november 2014 to september 2015. AAO guidelines were used for maculopathy screening including Humphrey visual field central 10-2 and spectral domain OCT. Photoreceptor’s mosaic images of the left eye were recorded using a flood-illumination AO retinal camera (RTX1 camera, Imagine Eyes). Two retinal zones were analyzed at 2° in superior and inferior from the fovea.

Results : In all patients, Humphrey visual field and OCT were between normal range values. In the overall population the cone density was negatively correlated with age in superior retina and inferior retina (r=-0.30, p=0,029; and r=-0.47, p<0,001, respectively). Age and sex adjusted means (standard deviation) of cone density were not different in patients taking HCQ as compared with patients with an auto-immune disease without HCQ and with controls (2° superior retina: 14224,55 [3642.19], 16848.10 [2899.96], 15316.20 [4028.9], p=0,054, respectively; 2° inferior retina: 14994.10 [3251.14], 15073.80 [3051.62], 14977.77 [3719.21], p=0.975, respectively).
In patients taking ≥6.5 mg/kg/j daily-dose of HCQ, 2° inferior mean cone density was lower as compared with patient having a dose <6,5 mg/kg/j daily-dose (13884.93 [2837.24] versus 16632.46 [3002.55], p=0,015, respectively). The cone density was not statistically correlated with daily-dose in the superior retina (p=0,155).
The 2° inferior mean cone density was lower in patients who received a cumulative dose ≥1000 g vs < 1000 g (13567.67 [2887.50] vs 17328.27 [2401.25], p<0,001).

Conclusions : After age and sex-adjustment, the cone density was not significantly decreased in patients taking HCQ as compared with controls. In patients taking HCQ the adjusted body weight dose over than 6,5mg/kg/j and a cumulated dose >1000 g were associated with a decreased cone density. AO imaging may be useful for early detection of HCQ toxicity.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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