Abstract :
Introduction: Hydroxychloroquine used in the management of connective tissue diseases also used to treat a wide spectrum of diseases. This disease-modifying anti-rheumatic drug can cause irreversible retinal damage and there are preferred practice guidelines for early screening to aid ophthalmologists and all those involved in the management of these patients. Spectral-Domain Optical Coherence Tomography (SD-OCT) currently an important tool in early detection of possible toxicity. Even with the current guideline-recommended 5mg/kg/day dosage, a baseline SD-OCT of the macula should be taken and repeated at 5 years. Many cross-sectional studies using SD-OCT have shown earlier retina damages, but none had monitored continuously from the beginning of Hydroxychloroquine usage.
Purpose: To evaluate sequential changes of the retina thickness in patients newly treated with hydroxychloroquine.
Materials and Methods: We compared the mean central macular and Retinal Nerve Fiber Layer (RNFL) thickness pre, 3 months and 6 months post hydroxychloroquine using SD-OCT in order to find an association between them over the three time-points.33 previously healthy patients who were newly confirmed clinically and serologically with connective tissue disease planned for hydroxychloroquine who fulfilled the inclusion and exclusion criteria were recruited over 2 years. In consideration of selection criteria and drop-out rate, finally, 26 patients were included in the study.
Results: 26 eyes of 26 patients (20 females and 6 males) were included in the study. The mean age was 33.92. The macula was significantly thinner (P
Conclusion: There is a need for an earlier repetition of SD-OCT imaging before 5 years to detect potential toxicity. Involvement of RNFL requires further investigation and monitoring.
Keyword :
Hydroxychloroquine, Plaquenil, RNFL Thinning, Macula thinning.