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Giulio Ruberto, Lorenzo Cavagna, Carmine Tinelli, Marta Raimondi, Valeria Mogavero, Patrizia Piccinini, Federica Borgaro, Laura Bossolesi; Follow-up of patients affected by rheumathoid arthritis and connectivities, under therapy with hydroxychloroquine or chloroquine via multifocal electroretinogram, frequency doubling technology, automated perimetry, optical coherence tomography and autofluorescence. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5106.
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To analyse either functional and morphologic alterations in patients affected by rheumatoid arthritis (RA) and connectivities (C) in therapy with hydroxychloroquine or chloroquine via multiple functional tests ,assessing the relationship of the performed tests with time and doses of administration.
We examined 60 patients affected by RA or C (mean age 55,4±13,6)in long term (93,1±87 months) therapy with anti malarial drugs. For the subsequent analysis patients were divided into 4 pathological groups, i.e. RA, systemic lupus erythematosus , C, other, assuming therapy from 0 to 5, 5 to 10 and more than 10 years. The affected subjects had a complete ophthalmologic visit, including logMAR visual acuity (VA), associated to multifocal electroretinogram (mfERG, 61 hexagons program), frequency doubling technology (FDT), automated perimetry (AP, program 10-2), optical coherence tomography (OCT) and autofluorescence (FA). The total mean drug amount was 588±572.8 grams. For the statistical analysis we considered the latencies and amplitudes of the 5 mfERG rings, the pattern and mean deviation (PSD,MD) results of the FDT and AP, the fiber thickness (FT) of the OCT and the FA positivity or negativity. Results had statistical analysis performed with parametric or non-parametric test depending on distribution data.
Mean VA was good (0 logMAR) in all the groups. We didn’t found statistically significant correlations in the mfERG amplitudes in all groups depending on the time or dose of drug assumption and for the PSD and the MD related to the AP and the FDT as well, nor for the OCT FT . We found however a trend to reduction of the mfERG rings P1 and N1 amplitudes in the RA and C group, while the PD and the MD showed a progressive loss of sensitivity. FA was positive in 13 patients.
This is the first step of a follow-up that will reexamine the same subjects after one and two years . Our goal is to identify the optimal and balanced therapy in those patients to avoid retinal damages.
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