title: Assessment of hydroxychloroquine maculopathy after cessation of treatment: an optical coherence tomography and multifocal electroretinography study.
abstract: OBJECTIVE
  This study was conducted to evaluate the macular status of patients treated with hydroxychloroquine before and after cessation of treatment.
  
  
  METHODS
  Forty-two patients with systemic lupus erythematosus underwent ocular examination based on visual acuity evaluation, optical coherence tomography retinal thickness measurements, and multifocal electroretinography (mfERG) records at first visit. The tests were repeated 6 months after treatment withdrawal and compared to the findings at their first visit.
  
  
  RESULTS
  Mean visual acuity (measured in log minimum angle of resolution) of both eyes was statistically increased after hydroxychloroquine discontinuation (difference in means: 0.06 [P<0.0001] and 0.01 [P=0.003] for the right and left eyes, respectively). Retinal response amplitudes of central and peripheral areas were significantly improved for both eyes. The following values were observed for central responses: the difference in means was -19.9 (P<0.0001) and -13.6 (P<0.0001) for the right eye and the left eye, respectively; for peripheral responses, difference in means was -10.3 (P<0.0001) and -9.5 (P<0.0001) for right eye and left eye, respectively, after the 6-month examination. There were no statistically significant differences in the retinal thickness of patients after cessation of treatment. The visual acuity of the patients was correlated to central and peripheral mfERG responses (r=-0.53 [P<0.0001] and r=-0.53 [P<0.0001], for the right eye and the left eye, respectively).
  
  
  CONCLUSIONS
  The visual acuity of patients receiving hydroxychloroquine improves along with the amplitudes of the mfERG responses 6 months after discontinuation of the drug, but no difference in retinal thickness is identified.
authors.affiliation: First Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Marilita M
authors.initials: MM
authors.lastname: Moschos
authors.affiliation: First Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Nitoda
authors.affiliation: First Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Irini P
authors.initials: IP
authors.lastname: Chatziralli
authors.affiliation: Swiss Eye Research Foundation, Orasis Eye Clinic, Reinach, Switzerland.
authors.forename: Zisis
authors.initials: Z
authors.lastname: Gatzioufas
authors.affiliation: First Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Chryssanthi
authors.initials: C
authors.lastname: Koutsandrea
authors.affiliation: Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kitsos
mesh_terms: D004596:Electroretinography; D005260:Female; D007839:Functional Laterality; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D012164:Retinal Diseases / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D006886:Hydroxychloroquine
keywords: hydroxychloroquine; multifocal electroretinography; optical coherence tomography; toxic retinopathy; visual acuity