D Martín-Iglesias1, J Artaraz2, A Fonollosa2, A Ugarte1, A Arteagabeitia2, G Ruiz-Irastorza1. 1. 1 Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Bizkaia, Basque Country, Spain. 2. 2 Ophthalmology Department, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Bizkaia, Basque Country, Spain.
Abstract
OBJECTIVE: The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). METHODS: SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. RESULTS: We studied 110 patients and 195 eyes. No cases of HCQ toxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. CONCLUSIONS: This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.
OBJECTIVE: The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). METHODS: SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. RESULTS: We studied 110 patients and 195 eyes. No cases of HCQtoxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. CONCLUSIONS: This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.
Authors: Celline C Almeida-Brasil; John G Hanly; Murray Urowitz; Ann Elaine Clarke; Guillermo Ruiz-Irastorza; Caroline Gordon; Rosalind Ramsey-Goldman; Michelle Petri; Ellen M Ginzler; D J Wallace; Sang-Cheol Bae; Juanita Romero-Diaz; Mary Anne Dooley; Christine Peschken; David Isenberg; Anisur Rahman; Susan Manzi; Søren Jacobsen; Sam Lim; Ronald F van Vollenhoven; Ola Nived; Andreas Jönsen; Diane L Kamen; Cynthia Aranow; Jorge Sanchez-Guerrero; Dafna D Gladman; Paul R Fortin; Graciela S Alarcón; Joan T Merrill; Kenneth Kalunian; Manuel Ramos-Casals; Kristján Steinsson; Asad Zoma; Anca Askanase; Munther A Khamashta; Ian N Bruce; Murat Inanc; Michal Abrahamowicz; Sasha Bernatsky Journal: Ann Rheum Dis Date: 2021-12-15 Impact factor: 27.973