Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

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ORIGINAL PAPER

Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy? Hatice Nur Tarakcioglu . Abdullah Ozkaya

. Ulviye Yigit

Received: 27 April 2020 / Accepted: 16 August 2020 Ó Springer Nature B.V. 2020

Abstract Purpose To detect the early changes in retinal vasculature via optical coherence tomography angiography (OCTA) by comparing the quantitative OCTA parameters in the group of patients who were using hydroxychloroquine (HCQ) or not. Methods This was a cross-sectional, comparative, and observational study. The patients who were newly or previously prescribed HCQ for an autoimmune disease were included. OCTA imaging was performed via OCT RT XR Avanti with AngioVue software (Optivue Inc, Freemont, CA). The study group had two groups: a control group (patients newly diagnosed and who were not taking any medication) and a treatment group (patients who were receiving HCQ

H. N. Tarakcioglu  U. Yigit Department of Ophthalmology, University of Health Sciences Bakirkoy Training and Research Hospital, Istanbul, Turkey e-mail: [email protected] U. Yigit e-mail: [email protected] A. Ozkaya (&) Department of Ophthalmology, Memorial Sisli Hospital, Okmeydani, Sisli, 34000 Istanbul, Turkey e-mail: [email protected] A. Ozkaya Department of Ophthalmology, Istanbul Aydin University, Istanbul, Turkey

treatment). The main outcome measure was OCTA parameters. Results A total of 102 eyes of 102 patients were included. There were 70 patients in the treatment group and 32 patients in the control group. All of the vascular density values were similar between the control and treatment groups (p [ 0.05 for all). However, the superficial whole thickness, superficial parafoveal thickness, superficial perifoveal thickness, deep whole thickness, deep parafoveal thickness, and deep perifoveal thickness were thinner in the treatment group than the control group (p \ 0.05 for all). Conclusion Vascular density parameters did not differ between the control and treatment groups. However, the retinal thickness values were lower in the treatment group. Keywords Angiography  Hydroxychloroquine  Optical coherence tomography  Retinopathy

Introduction Chloroquines which are originally antimalarial drugs are now being widely used in the treatment of autoimmune diseases [1, 2]. Also, they are used as emerging treatment options for skin, oncologic, and pediatric inflammatory disorders [3]. Surprisingly, chloroquines are now widely used as a first-line drug

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in the treatment of—new coronavirus infection— COVID-19 [4]. The first drug of the group was chloroquine, and less toxic variant hydroxychloroquine (HCQ) was developed later [3, 5]. Chloroquines have toxic effects on retina and eventually lead to socalled bull’s eye maculopathy [3]. The optimum safe dose of the drug is still debatable. Traditionally HCQ was used based on ideal body weight (IBW); however, it was reported that in some cases, actual body weig