Abstract
Purpose: :
To analyze functional and anatomic retinal changes in patients treated with hydroxychloroquine for at least five years.
Methods: :
21 patients on hydroxychloroquine and 21 controls were included in this study between May and December 2010. Patients were divided into sub-groups according to daily hydroxychloroquine intake ( ≤ 6, 5 mg/ideal weight/day or > 6,5 mg/ideal weight/day) and cumulative doses (< 1000g or > 1000g). All patients were clinically asymptomatic and underwent a complete ophthalmologicexamination as well as the following tests: central 10° visual field, fundus autofluorescence (AF) imaging, Spectral Domain optical coherence tomography (SD OCT) and multifocal electroretinogram (mfERG). All controls underwent a complete ophthalmologic examination and SD OCT. We analyzed the macular ganglion cell complex (mGCC) on SD OCT.
Results: :
The average amplitude of the P1 wave of the 2 - 5° central ring was lower (p<0.03) in the patient sub-group cumulative dose >1000g than in the sub-group cumulative dose <1000g. There was no statistically significant difference in the average values of the P1 wave amplitude on mf ERG between sub-group daily dose ≤6.5mg/ideal weight/day and sub-group daily dose >6.5mg/ideal weight/day. The mfERG ring ratios were also compared including R1/R2, R1/R3, R1/R4, R1/R5, R1/R6. No statistically significant difference was found in mfERG ring ratios between the patient sub-group cumulative dose >1000g and the sub-group cumulative dose <1000g or the sub-group daily dose ≤6.5mg/ideal weight/day and the sub-group daily dose >6.5mg/ideal weight/day. All patients had a normal photoreceptor inner segment-outer segment junction line on SD OCT. No statistically significant difference was observed in average retinal thickness values of the macular ganglion cell complex between patient group and control group. However, the correlation analysis seems to provide additional information (significant and positive correlations for controls become no significant and negative for patients) that may be included in the results and which show the potential value of SD OCT.
Conclusions: :
We detected some elements of changes with SD OCT and mfERG but not clearly toxicity.
Keywords: drug toxicity/drug effects • retina • electroretinography: clinical