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Inner retina changes in hydroxychloroquine patients
Author(s) -
Barata A.,
Leal I.,
Sousa F.,
Teixeira F.,
Pinto F.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.01517
Subject(s) - retinal , foveal , ophthalmology , retina , medicine , ganglion cell layer , inner plexiform layer , inner nuclear layer , fovea centralis , outer nuclear layer , nerve fiber layer , hydroxychloroquine , outer plexiform layer , covid-19 , biology , neuroscience , disease , infectious disease (medical specialty)
Purpose To study if hydroxychloroquine (HCQ) patients with apparent no retinal toxicity will show lower retinal thickness in inner layers as compared to healthy controls. Methods Retrospective study of 43 patients (86 eyes) evaluated for HCQ macular toxicity with spectral‐domain OCT (SD‐OCT) and with no OCT signs of maculopathy were subdivided into two groups: (1) no blunting of the foveal contour (foveal splaying), (2) with foveal splaying. Age and sex‐matched controls were used for comparison. Automated retinal layer segmentation at the center of fovea and at a radius of 3 (parafoveal) to 6mm (perifoveal) from the superior, inferior, temporal and nasal sectors was performed. Statistical analysis using two sample t ‐test was made to calculate significant results between groups. Results Center macular and internal retinal layers thickness in all parafoveal sectors, particularly in the retinal nerve fibre (RNFL) and ganglion cell layer (GCL), was statistically reduced when compared to control group (p < 0.05) and differed between group 1 and 2. RNFL thickness was also reduced in all perifoveal sectors but temporal sector (p < 0.05) and inner plexiform layer and inner nuclear layer thickness showed only significant reduction in foveal and nasal parafoveal sector (p < 0.05) in HCQ eyes. No significant differences in outer layers was observed between groups. Conclusions Small changes in inner retinal layers thickness have been described with HCQ use and conflicting correlation with HCQ toxicity is present in the literature. This study supports that inner retina at the fovea and parafovea is thinner in patients with no outer retinal OCT signs of HCQ toxicity. Further investigation is needed to assess if an inner retinal thickness reduction threshold could serve as valuable tool for identifying patients with increased risk of HCQ maculopathy.