Early morpho-functional changes in patients treated with hydroxychloroquine

a prospective cohort study

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: We aimed to find earlier morphological and functional alterations in the retinas of patients treated with hydroxychloroquine (HCQ). This was a prospective cohort study. Methods: We examined 33 patients (mean age, 57.14 [SD, 11.02] years) who were affected by various types of rheumatic diseases. The mean treatment period was 124.7 [SD, 99.4] months, and the mean total drug intake was 5.41 [SD, 3.34] g daily at baseline. The control group consisted of 28 subjects with a mean age of 61.25 [SD, 2.16 years]. The set of tests encompassed best-corrected visual acuity (BCVA), a multifocal electroretinogram (mfERG), spectral-domain optical coherence tomography (SD-OCT), fundus auto fluorescence (FAF), the 10-2 automated visual field (VF) test (10-2 VF), and frequency-doubling technology (FDT). Results: The mfERG P1 wave density amplitudes decreased in all the rings, from 31.10 to 28.02 (p = 0.008) in the first ring, and from 18.29 to 16.55 [p < 0.001], from 12.050 to 10.91 [p = 0.002], from 9.53 to 8.69 [p = 0.003], and from 8.25 to 7.48 [p = 0.001] nanovolts/degree2 in rings 2, 3, 4, and 5, respectively. A significant reduction was found also in the N1 wave in the second ring. The SD-OCT retinal thickness measurement revealed significant thinning in five sectors, including the outer and inner nasal sectors, the outer and inner temporal sectors, and the inner superior sector. The 10-2 VF mean deviation paradoxically improved, while minimal FAF alterations in the retinal pigment epithelium were found in eight eyes. Conclusions: mfERGs and SD-OCT were altered in our patients before significant retinal changes occurred.

Original languageEnglish
Pages (from-to)2201-2210
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume256
Issue number11
DOIs
Publication statusPublished - 2018
Externally publishedYes

Fingerprint

Hydroxychloroquine
Optical Coherence Tomography
Cohort Studies
Prospective Studies
Visual Fields
Fluorescence
Visual Field Tests
Retinal Pigment Epithelium
Rheumatic Diseases
Nose
Evoked Potentials
Visual Acuity
Retina
Technology
Control Groups
Pharmaceutical Preparations
Therapeutics

Keywords

  • Frequency-doubling technology
  • Hydroxychloroquine
  • Maculopathy
  • mfERG
  • SD-OCT
  • Visual field

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

@article{0da499c112e34d9abf5438d2533ffe99,
title = "Early morpho-functional changes in patients treated with hydroxychloroquine: a prospective cohort study",
abstract = "Purpose: We aimed to find earlier morphological and functional alterations in the retinas of patients treated with hydroxychloroquine (HCQ). This was a prospective cohort study. Methods: We examined 33 patients (mean age, 57.14 [SD, 11.02] years) who were affected by various types of rheumatic diseases. The mean treatment period was 124.7 [SD, 99.4] months, and the mean total drug intake was 5.41 [SD, 3.34] g daily at baseline. The control group consisted of 28 subjects with a mean age of 61.25 [SD, 2.16 years]. The set of tests encompassed best-corrected visual acuity (BCVA), a multifocal electroretinogram (mfERG), spectral-domain optical coherence tomography (SD-OCT), fundus auto fluorescence (FAF), the 10-2 automated visual field (VF) test (10-2 VF), and frequency-doubling technology (FDT). Results: The mfERG P1 wave density amplitudes decreased in all the rings, from 31.10 to 28.02 (p = 0.008) in the first ring, and from 18.29 to 16.55 [p < 0.001], from 12.050 to 10.91 [p = 0.002], from 9.53 to 8.69 [p = 0.003], and from 8.25 to 7.48 [p = 0.001] nanovolts/degree2 in rings 2, 3, 4, and 5, respectively. A significant reduction was found also in the N1 wave in the second ring. The SD-OCT retinal thickness measurement revealed significant thinning in five sectors, including the outer and inner nasal sectors, the outer and inner temporal sectors, and the inner superior sector. The 10-2 VF mean deviation paradoxically improved, while minimal FAF alterations in the retinal pigment epithelium were found in eight eyes. Conclusions: mfERGs and SD-OCT were altered in our patients before significant retinal changes occurred.",
keywords = "Frequency-doubling technology, Hydroxychloroquine, Maculopathy, mfERG, SD-OCT, Visual field",
author = "Giulio Ruberto and Carlo Bruttini and Carmine Tinelli and Lorenzo Cavagna and Alessandro Bianchi and Giovanni Milano",
year = "2018",
doi = "10.1007/s00417-018-4103-9",
language = "English",
volume = "256",
pages = "2201--2210",
journal = "Graefe's Archive for Clinical and Experimental Ophthalmology",
issn = "0721-832X",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Early morpho-functional changes in patients treated with hydroxychloroquine

T2 - a prospective cohort study

AU - Ruberto, Giulio

AU - Bruttini, Carlo

AU - Tinelli, Carmine

AU - Cavagna, Lorenzo

AU - Bianchi, Alessandro

AU - Milano, Giovanni

PY - 2018

Y1 - 2018

N2 - Purpose: We aimed to find earlier morphological and functional alterations in the retinas of patients treated with hydroxychloroquine (HCQ). This was a prospective cohort study. Methods: We examined 33 patients (mean age, 57.14 [SD, 11.02] years) who were affected by various types of rheumatic diseases. The mean treatment period was 124.7 [SD, 99.4] months, and the mean total drug intake was 5.41 [SD, 3.34] g daily at baseline. The control group consisted of 28 subjects with a mean age of 61.25 [SD, 2.16 years]. The set of tests encompassed best-corrected visual acuity (BCVA), a multifocal electroretinogram (mfERG), spectral-domain optical coherence tomography (SD-OCT), fundus auto fluorescence (FAF), the 10-2 automated visual field (VF) test (10-2 VF), and frequency-doubling technology (FDT). Results: The mfERG P1 wave density amplitudes decreased in all the rings, from 31.10 to 28.02 (p = 0.008) in the first ring, and from 18.29 to 16.55 [p < 0.001], from 12.050 to 10.91 [p = 0.002], from 9.53 to 8.69 [p = 0.003], and from 8.25 to 7.48 [p = 0.001] nanovolts/degree2 in rings 2, 3, 4, and 5, respectively. A significant reduction was found also in the N1 wave in the second ring. The SD-OCT retinal thickness measurement revealed significant thinning in five sectors, including the outer and inner nasal sectors, the outer and inner temporal sectors, and the inner superior sector. The 10-2 VF mean deviation paradoxically improved, while minimal FAF alterations in the retinal pigment epithelium were found in eight eyes. Conclusions: mfERGs and SD-OCT were altered in our patients before significant retinal changes occurred.

AB - Purpose: We aimed to find earlier morphological and functional alterations in the retinas of patients treated with hydroxychloroquine (HCQ). This was a prospective cohort study. Methods: We examined 33 patients (mean age, 57.14 [SD, 11.02] years) who were affected by various types of rheumatic diseases. The mean treatment period was 124.7 [SD, 99.4] months, and the mean total drug intake was 5.41 [SD, 3.34] g daily at baseline. The control group consisted of 28 subjects with a mean age of 61.25 [SD, 2.16 years]. The set of tests encompassed best-corrected visual acuity (BCVA), a multifocal electroretinogram (mfERG), spectral-domain optical coherence tomography (SD-OCT), fundus auto fluorescence (FAF), the 10-2 automated visual field (VF) test (10-2 VF), and frequency-doubling technology (FDT). Results: The mfERG P1 wave density amplitudes decreased in all the rings, from 31.10 to 28.02 (p = 0.008) in the first ring, and from 18.29 to 16.55 [p < 0.001], from 12.050 to 10.91 [p = 0.002], from 9.53 to 8.69 [p = 0.003], and from 8.25 to 7.48 [p = 0.001] nanovolts/degree2 in rings 2, 3, 4, and 5, respectively. A significant reduction was found also in the N1 wave in the second ring. The SD-OCT retinal thickness measurement revealed significant thinning in five sectors, including the outer and inner nasal sectors, the outer and inner temporal sectors, and the inner superior sector. The 10-2 VF mean deviation paradoxically improved, while minimal FAF alterations in the retinal pigment epithelium were found in eight eyes. Conclusions: mfERGs and SD-OCT were altered in our patients before significant retinal changes occurred.

KW - Frequency-doubling technology

KW - Hydroxychloroquine

KW - Maculopathy

KW - mfERG

KW - SD-OCT

KW - Visual field

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