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Optical coherence tomography angiography for screening of hydroxychloroquine-induced retinal alterations

  • Retinal Disorders
  • Published:
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Abstract

Background/aims

The purpose of the study was to evaluate the retinal and choroidal changes via optical coherence tomography angiography (OCTA) in patients who received hydroxychloroquine (HCQ).

Methods

Sixty eyes of 60 female patients who received HCQ were included in the study. Patients were categorized into two groups as high-risk (≥ 5 years) and low-risk (< 5 years) in terms of HCQ-induced retinal toxicity. Spectral domain-OCT, OCTA, and visual field tests were performed. Retinal thickness, vascular density, flow rates, choroidal thickness (CT), and visual field parameters were compared between the groups, and the correlation between total HCQ cumulative dose, duration of use, and these parameters was assessed.

Results

Compared to low-risk group, patients in the high-risk group had vascular density loss (p < 0.05). In this group, foveal avascular zone (FAZ) was found to be wider (p < 0.05). Retinal and choroidal flow rates were found to be decreased markedly in the high-risk group (p < 0.05). CT was found to be thinner in the high-risk group (p < 0.05). HCQ cumulative dose and duration of use had a negative significant correlation with all vascular density, flow rate, CT parameters, and positive significant correlation with FAZ parameters (p < 0.05). In visual field tests, mean defect (MD) was found to be increased in the high-risk group (p < 0.05). Moreover, MD had a positive correlation with HCQ cumulative dose and duration of use (p < 0.05).

Conclusions

Evaluation of microvascular changes via OCTA may contribute to the early detection of HCQ-induced retinal toxicity, which cannot be detected through other imaging devices, at the stage when it is reversible.

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Contributors

MB and HFC carried out the study. MB, MA, and MKE finished data collection and statistical analysis. MB, OG, and MA wrote the paper and revised the manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Antalya Training and Research Hospital, University of Health Sciences, Varlik Mahallesi, Kazim Karabekir Caddesi, 07100, Antalya, Turkey

    Mehmet Bulut, Melih Akıdan, Muhammet Kazım Erol & Ayşe Cengiz

  2. Department of Ophthalmology, Medicalpark Hospital, Antalya, Turkey

    Onursal Gözkaya

  3. Department of Rheumatology, Physical Medicine Rehabilitation, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey

    Hasan Fatih Çay

Authors
  1. Mehmet Bulut
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  2. Melih Akıdan
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  3. Onursal Gözkaya
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  4. Muhammet Kazım Erol
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  5. Ayşe Cengiz
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  6. Hasan Fatih Çay
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Corresponding author

Correspondence to Mehmet Bulut.

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Declaration of conflicting interests

The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted at University of Health Sciences Antalya Training and Research Hospital according to Helsinki Declaration following the approval of the local ethics board.

Informed consent

The patients were informed about the study and signed the informed consent forms.

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Cite this article

Bulut, M., Akıdan, M., Gözkaya, O. et al. Optical coherence tomography angiography for screening of hydroxychloroquine-induced retinal alterations. Graefes Arch Clin Exp Ophthalmol 256, 2075–2081 (2018). https://doi.org/10.1007/s00417-018-4117-3

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  • DOI: https://doi.org/10.1007/s00417-018-4117-3

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