Optical cohorence tomography and microperimetric changes in patients using hydoxychloroquine

Purpose: To evaluate early determination performance of retinal damage in patients who use hydroxychloroquine (HQ) with retinal nerve fiber layer thickness, macular thickness and microperimetric measurements.Materials and Methods: This study was performed in Çukurova University (Adana, Turkey) Ophthalmology Department. Thirty-five women who use hydroxychloroquine and consulted by Rheumatolgy Department included to this study and compared with 35 healthy women (control group). After a detailed ophthalmic examination, 10-2 static threshold computerized visual field test, retinal nerve fiber layer thickness, macular thickness and SLO-OCT microperimetry measurements were performed to both groups. The collected data analyzed to determine the risc factors and correlations between two groups.Results: Mean age was 42.6 ± 11.26 years in HQ group and 39.57 ± 8.55 years in control group. Mean HQ usage was 36.14 ± 34.9 months and the cumulative dose was 336,69±243,37 g. MD and PSD values were 2,55±1,48-1,94±0,9 in HQ and 1.88 ± 0.7 to 1.68 ± 0.52 in control group. The mean retinal nerve fiber layer thickness values in superior, inferior, nasal, temporal quadrants were 120,74±14,88 µ, 130,77±16,29 µ, 128,67±16,95 µ, 131,83±18,14µ in HQ and 75,51±14,13 µ, 81,94±14,45 µ, 72,4±11,93 µ, 78,4±12,85 µ in control group. Mean macular thickness values in central, central ring, superior, inferior, nasal, temporal quadrants were 124,84±66,68 µ,129,09±61,93 µ, 172,2±58,95 µ,182,9±44,52 µ, 278,67±28,54 µ,285,5±36,75µ, 276,94±36,48 µ, 288,27±35,22 µ in HQ and 261,54±47,66 µ, 276,89±36,49 µ, 242,66±55,81 µ, 273,44±33,25 µ, 255,56±35,94 µ, 270,47±28,34 µ in control group. Mean values of retinal sensitivity and microperimetric test score were 504,44±85,22 / 12,4±2,14 dB in HQ, 510,94±95,02 /12,75±2,38 dB in control group.Conclusion: There were statistically significant difference between HQ and control groups in visual field test, all quadrants of retinal nerve fiber layer thickness except inferior quadrant, all parafoveal quadrants of macular thickness except central-central ring quadrants and total macular thickness measurements. There were no statistically significant difference between two groups in microperimetric test score, retinal sensitivity values and fixation pattern measurements. There was a correlation in HQ group between age, usage time, total dosage, visaul field test sensitivity, microperimetric retinal sensitivity and test score values. No correlation found between macular thickness, retinal nerve fiber layer thickness values. Consequently the combination of the functional measurements with the other retinal imaging measurements will help to understand the futher investigations of retinal pathophisiologies.Keywords: hydroxychloroquine retinopathy, microperimetry, optical coherence.