Decreased peri-parafoveal RPE, EZ and ELM intensity: A novel predictive biomarker for hydroxychloroquine retinal toxicity.

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  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 8205248 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-702X (Electronic) Linking ISSN: 0721832X NLM ISO Abbreviation: Graefes Arch Clin Exp Ophthalmol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin ; New York : Springer-Verlag, c1982-
    • Subject Terms:
      Hydroxychloroquine*/adverse effects ; Hydroxychloroquine*/toxicity ; Tomography, Optical Coherence*/methods ; Retinal Diseases*/chemically induced ; Retinal Diseases*/diagnosis ; Fovea Centralis*/pathology ; Fovea Centralis*/drug effects ; Retinal Pigment Epithelium*/drug effects ; Retinal Pigment Epithelium*/pathology ; Visual Acuity* ; Antirheumatic Agents*/adverse effects; Humans ; Female ; Male ; Middle Aged ; Basement Membrane ; Fluorescein Angiography/methods ; Retrospective Studies ; Adult ; Biomarkers/metabolism ; Fundus Oculi ; Follow-Up Studies ; Aged
    • Abstract:
      Purpose: To evaluate the reflectivities of the retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) in the central fovea, perifoveal, and parafoveal regions with Optical Coherence Tomography (OCT) and the change in choroid vascular index (CVI) in patients using hydroxychloroquine (HCQ).
      Methods: Sixty-one patients underwent HCQ treatment; age and sex-matched 44 control group subjects were included in the study. The RPE, EZ, and ELM reflectivities were measured with the ImageJ program at 5 points, and CVI was calculated.
      Results: RPE, EZ, and ELM reflectivities in the central fovea were higher in the HCQ group than in the control group (p < 0.001, p = 0.013, p = 0.022). In the HCQ group, there was a decrease in RPE reflectivities in the temporal, nasal parafovea, and nasal perifovea (p = 0.001, p = 0.03, p = < 0.001). EZ and ELM reflectivity in the nasal parafovea and nasal perifovea was lower in the patient group than in the control group (p = 0.007, p = 0.005, p = 0.009, p = 0.001). In the HCQ group, all absolute para and perifoveal reflectivities relative to the fovea decreased significantly more than in the control group (p < 0.05).
      Conclusion: In patients who underwent HCQ treatment, there is a decrease in the reflectivities of the para and perifoveal RPE, EZ, and ELM compared to the fovea. This decrease is more pronounced than the decrease in reflectivity in the para and perifoveal regions compared to the fovea in people who do not use HCQ. This situation can be considered as a sign of toxicity that is a precursor to overt maculopathy.
      Competing Interests: Declarations. Ethical approval: This study protocol was approved by Haydarpasa Numune Training and Research Hospital Clinical Research Ethics Committee (HNEAH-KAEK 2023/KK/101). Informed consent: Informed consent was waived due to the retrospective nature of this study. Conflict of interest: The authors declare that they have no conflict of interest.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Ellipsoid zone; External limiting membrane; Hydroxychloroquine; Parafoveal; Perifoveal
    • Accession Number:
      4QWG6N8QKH (Hydroxychloroquine)
      0 (Antirheumatic Agents)
      0 (Biomarkers)
    • Publication Date:
      Date Created: 20240605 Date Completed: 20241122 Latest Revision: 20241125
    • Publication Date:
      20241126
    • Accession Number:
      PMC11584423
    • Accession Number:
      10.1007/s00417-024-06532-8
    • Accession Number:
      38836942