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ORIGINAL ARTICLE
Year : 2020  |  Volume : 32  |  Issue : 1  |  Page : 60-65

Early detection of retinal changes in patients using hydroxychloroquine – An optical coherence tomography-based study


1 Department of Ophthalmology, Jubilee Mission Medical College And Research Institute, Thrissur, Kerala, India
2 Department of Dermatology, Jubilee Mission Medical College And Research Institute, Thrissur, Kerala, India
3 Department of Medicine, Jubilee Mission Medical College And Research Institute, Thrissur, Kerala, India

Correspondence Address:
Dr. Aiswarya Sasidharan
Department of Ophthalmology, Jubilee Mission Medical College and Research Institute, Thrissur - 680 005, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_91_19

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Background: Hydroxychloroquine (HCQ) is an antimalarial drug, which is now the mainstay treatment for autoimmune diseases. HCQ retinopathy is rare, but it is generally irreversible and can progress even after cessation of drug therapy. The screening tests recommended are dilated fundus examination, color vision, and Humphrey 10-2 visual fields. Now, it is recommended that at least one of the newer modalities such as multifocal electroretiogram and spectral-domain optical coherence tomography (SD-OCT) be used according to availability. The present study is to evaluate the early retinal toxic effects of HCQ using SD-OCT before the symptomatic visual loss or fundus changes have occurred and to assess the correlation between HCQ cumulative dose and effects on the retina. Materials and Methods: A comparative cross-sectional study was performed in 132 patients (66 cases and 66 controls). Macular thickness in nine segments, ganglion cell-inner plexiform layer (GC-IPL) thickness in six segments was assessed using Cirrus HD-OCT and compared with the control group. HCQ cumulative dose was calculated and compared with the retinal thickness. Results: Macular thickness showed statistically significant thinning in six out of nine segments. GC-IPL thickness showed thinning in all six segments. A significant negative correlation was obtained on comparison of HCQ cumulative dose and GC-IPL and macular thickness average. Conclusions: SD-OCT can be used for detecting retinal thinning and GC-IPL thinning in patients on HCQ to detect early structural and functional changes in retina due to HCQ toxicity before any visual symptoms or fundus changes occur.


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