June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Longitudinal Assessment of Increased Ellipsoid Zone Attenuation Associated with Hydroxychloroquine Use: Possible Role for Automated Toxicity Detection
Author Affiliations & Notes
  • Stephanie Kaiser
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Katherine Talcott
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Atsuro Uchida
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Obinna Ugwuegbu
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Ming Hu
    Lerner Research Institute, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Thuy Le
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Leina Lunasco
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Jamie Reese
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Justis Ehlers
    Cole Eye Institute, Pepper Pike, Ohio, United States
  • Footnotes
    Commercial Relationships   Stephanie Kaiser, None; Katherine Talcott, Chengdu Kanghong Biotechnology (F), Novartis (F); Atsuro Uchida, None; Obinna Ugwuegbu, None; Ming Hu, None; Sunil Srivastava, Allergan (F), Bausch and Lomb (C), Gilead (F), Leica (P), Regeneron (F), Santen (C); Thuy Le, None; Leina Lunasco, None; Jamie Reese, None; Justis Ehlers, Aerpio (F), Aerpio (C), Alcon (F), Alcon (C), Allegro (C), Allergan (F), Allergan (C), Genentech (F), Genentech/Roche (C), Leica (C), Leica (P), Novartis (F), Novartis (C), Regeneron (F), Regeneron (C), Santen (C), Thrombogenics/Oxurion (F), Thrombogenics/Oxurion (C), Zeiss (C)
  • Footnotes
    Support  RPB Unrestricted Grant to the Cole Eye Institute RPB1508DM, NIH K23 -EY022947
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2566. doi:
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      Stephanie Kaiser, Katherine Talcott, Atsuro Uchida, Obinna Ugwuegbu, Ming Hu, Sunil K Srivastava, Thuy Le, Leina Lunasco, Jamie Reese, Justis Ehlers; Longitudinal Assessment of Increased Ellipsoid Zone Attenuation Associated with Hydroxychloroquine Use: Possible Role for Automated Toxicity Detection. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2566.

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

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Abstract

Purpose : To evaluate longitudinal OCT threshold changes in ellipsoid zone (EZ) attenuation that may precede overt hydroxychloroquine (HCQ) toxicity using an automated EZ mapping platform.

Methods : All participants underwent macular cube scan at two time points using the Cirrus HD-OCT, which were imported and analyzed in an automated retinal layer and EZ mapping segmentation platform. Clinical characteristics were collected. Longitudinal change in en face percentage of en face EZ attenuation (EZ thickness < 20μm). Clinical factors associated with an absolute longitudinal en face EZ partial attenuation increase of 4% were analyzed.

Results : Four hundred one eyes of 401 patients were included. Mean age was 57.6±13.0 years, daily mean HCQ dose was 367.1±72.6 mg, mean actual body weight (ABW) dose was 4.9±1.6 mg/kg, and mean ideal body weight dose was 6.6±1.6 mg/kg. Mean drug duration was 5.8±3.9 years and mean interval between OCTs was 3.1±0.9 years. There was a significant increase in en face EZ attenuation from the first (4.7±18.2%) to the second OCT (5.8±19.1%; p=0.02). An increase in en face EZ attenuation of 4% or more was significantly associated with age of HCQ initiation (p<0.001), age at time of the first (p<0.001) and second OCT (p<0.001), VA at the first (p<0.001) and second (p<0.001) OCT, cumulative HCQ dose at the second OCT (p=0.02), actual body weight HCQ dose (p=0.02), and ideal body weight HCQ dose (p=0.008).

Conclusions : Longitudinal OCT assessment revealed a significant increase in EZ attenuation which correlated with age, daily dose, and dose based on actual as well as ideal body weight. Additional research is needed to further validate these subclinical progressive changes, to further characterize the long-term significance of these changes, and their impact on identification of HCQ toxicity.

This is a 2020 ARVO Annual Meeting abstract.

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