Hande Husniye Telek1, Nilufer Yesilirmak2, Gulten Sungur1, Yaprak Ozdemir3, Nesibe Karahan Yesil4, Firdevs Ornek1. 1. Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey. 2. Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey. dryesilirmak@gmail.com. 3. Department of Statistics, Gazi University Faculty of Sciences, Ankara, Turkey. 4. Department of Rheumatology, Ankara Training and Research Hospital, Ankara, Turkey.
Abstract
PURPOSE: To compare the retinal toxicity due to hydroxychloroquine (HCQ) use in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) using multifocal electroretinography (mfERG), fundus autofluorescence (FAF) and optical coherence tomography (OCT). METHODS: Patients who were using HCQ due to SLE and RA, and healthy subjects evaluated in this study. Central foveal thickness (CFT), inner-outer segment (IS-OS) junction irregularity, retinal nerve fiber layer thickness, mfERG and FAF measurements were performed to evaluate retinal toxicity. RESULTS: Study included 35 eyes of 35 SLE patients, 40 eyes of 40 RA patients and 20 eyes of 20 healthy subjects. In SLE group, retinal abnormality was found in three eyes with mfERG, in one eye with FAF and in four eyes with OCT. In RA group, retinal abnormality was found in 10 eyes with mfERG, in five eyes with FAF and in nine eyes with OCT. A statistically significant difference was found with respect to mfERG between "eyes with abnormal responses and without abnormal responses" and "eyes with abnormal responses and controls" (p < 0.05). A statistically significant difference was found with respect to CFT between "eyes with IS-OS junction irregularities and without IS-OS junction irregularities" and "eyes with/without IS-OS junction irregularities and controls" (p < 0.05). CONCLUSIONS: The use of HCQ seems to cause retinal toxicity more often in RA patients compared to SLE patients. For the early detection of retinal changes, OCT and mfERG can be used as screening tools due to their higher sensitivity rates compared to other tests.
PURPOSE: To compare the retinal toxicity due to hydroxychloroquine (HCQ) use in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) using multifocal electroretinography (mfERG), fundus autofluorescence (FAF) and optical coherence tomography (OCT). METHODS:Patients who were using HCQ due to SLE and RA, and healthy subjects evaluated in this study. Central foveal thickness (CFT), inner-outer segment (IS-OS) junction irregularity, retinal nerve fiber layer thickness, mfERG and FAF measurements were performed to evaluate retinal toxicity. RESULTS: Study included 35 eyes of 35 SLEpatients, 40 eyes of 40 RApatients and 20 eyes of 20 healthy subjects. In SLE group, retinal abnormality was found in three eyes with mfERG, in one eye with FAF and in four eyes with OCT. In RA group, retinal abnormality was found in 10 eyes with mfERG, in five eyes with FAF and in nine eyes with OCT. A statistically significant difference was found with respect to mfERG between "eyes with abnormal responses and without abnormal responses" and "eyes with abnormal responses and controls" (p < 0.05). A statistically significant difference was found with respect to CFT between "eyes with IS-OS junction irregularities and without IS-OS junction irregularities" and "eyes with/without IS-OS junction irregularities and controls" (p < 0.05). CONCLUSIONS: The use of HCQ seems to cause retinal toxicity more often in RApatients compared to SLEpatients. For the early detection of retinal changes, OCT and mfERG can be used as screening tools due to their higher sensitivity rates compared to other tests.
Authors: Julio A Rodriguez-Padilla; Thomas R Hedges; Bryan Monson; Vivek Srinivasan; Maciej Wojtkowski; Elias Reichel; Jay S Duker; Joel S Schuman; James G Fujimoto Journal: Arch Ophthalmol Date: 2007-06