title: Effect of Hydroxychloroquine on the Retinal Layers: A Quantitative Evaluation with Spectral-Domain Optical Coherence Tomography.
abstract: Purpose. To evaluate the effect of hydroxychloroquine on retinal pigment epithelium- (RPE-) Bruch's membrane complex, photoreceptor outer segment, and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods. In this prospective case-control study, 51 eyes of 51 hydroxychloroquine patients and 30 eyes of 30 healthy subjects were included. High-quality images were obtained using a Cirrus HD-OCT with 5-line raster mode; the photoreceptor inner segment (IS) and outer segment (OS), sum of the segments (IS + OS), and RPE-Bruch's membrane complex were analyzed. Results. The thicknesses of the IS + OS and OS layers were significantly lower in the hydroxychloroquine subjects compared to the control subjects (P < 0.05). RPE-Bruch's membrane complex thicknesses were significantly higher in the hydroxychloroquine subjects than for those of the control subjects (P < 0.05). The minimum and temporal-inferior macular GCIPL thicknesses were significantly different between the patients with hydroxychloroquine use and the control subjects (P = 0.04 and P = 0.03, resp.). Conclusions. The foveal photoreceptor OS thinning, loss of GCIPL, and RPE-Bruch's membrane thickening were detected in patients with hydroxychloroquine therapy. This quantitative approach using SD-OCT images may have important implications to use as an early indicator of retinal toxicity without any visible signs of hydroxychloroquine retinopathy.
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Hasim
authors.identifier: 0000-0002-6362-2056
authors.initials: H
authors.lastname: Uslu
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Gurler
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Yildirim
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Mehmet Gurkan
authors.identifier: 0000-0003-3419-4838
authors.initials: MG
authors.lastname: Tatar
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Feride
authors.identifier: 0000-0002-0123-4568
authors.initials: F
authors.lastname: Aylin Kantarcı
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Goker
authors.affiliation: Department of Rheumatology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Hatice Seval
authors.initials: HS
authors.lastname: Pehlevan
authors.affiliation: Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey.
authors.forename: Hatice Nur
authors.identifier: 0000-0003-2038-9001
authors.initials: HN
authors.lastname: Colak