Lee Min Gyu, Kim Sang Jin, Ham Don-Il, Kang Se Woong, Kee Changwon, Lee Jaejoon, Cha Hoon-Suk, Koh Eun-Mi
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2014 Nov 25;56(1):396-402. doi: 10.1167/iovs.14-15138.
We evaluated macular ganglion cell-inner plexiform layer (GC-IPL) thickness using spectral-domain optical coherence tomography (SD-OCT) in patients with chronic exposure to hydroxychloroquine (HCQ).
This study included 130 subjects, who were divided into three groups: Group 1A, 55 patients with HCQ use ≥5 years; Group 1B, 46 patients with HCQ use <5 years; and Group 2, 29 normal controls. In all patients with exposure to HCQ, fundus examination, automated threshold perimetry, fundus autofluorescence photography, SD-OCT, and GC-IPL thickness measurement using the Cirrus HD-OCT ganglion cell analysis algorithm were performed. Average and minimum macular GC-IPL thickness were compared between subjects groups, and correlations between GC-IPL thickness and duration or total dose of HCQ use were analyzed.
Among the 101 patients of Group 1, six patients who showed clinically evident HCQ retinopathy also showed markedly thin macular GC-IPL. In addition, weak but significant negative correlations were observed between the average and minimum GC-IPL thickness of Group 1 patients and cumulative dose of HCQ, even when analyzing without the six patients with HCQ retinopathy. However, when analyzing after exclusion of patients with high cumulative doses (>1000 g), significant correlations were not observed.
This study revealed that macular GC-IPL thickness did not show definite correlations with HCQ use. However, some patients, especially with HCQ retinopathy or high cumulative doses, showed thin GC-IPL.
我们使用光谱域光学相干断层扫描(SD - OCT)评估长期接触羟氯喹(HCQ)患者的黄斑神经节细胞 - 内丛状层(GC - IPL)厚度。
本研究纳入130名受试者,分为三组:1A组,55名使用HCQ≥5年的患者;1B组,46名使用HCQ<5年的患者;2组,29名正常对照者。对所有接触HCQ的患者进行眼底检查、自动阈值视野检查、眼底自发荧光摄影、SD - OCT以及使用Cirrus HD - OCT神经节细胞分析算法测量GC - IPL厚度。比较各受试者组之间黄斑GC - IPL的平均厚度和最小厚度,并分析GC - IPL厚度与HCQ使用时间或总剂量之间的相关性。
在1组的101名患者中,6名表现出临床明显HCQ视网膜病变的患者也显示黄斑GC - IPL明显变薄。此外,即使在分析时排除6名患有HCQ视网膜病变的患者,1组患者的GC - IPL平均厚度和最小厚度与HCQ累积剂量之间仍观察到弱但显著的负相关。然而,在排除累积剂量高(>1000 g)的患者后进行分析时,未观察到显著相关性。
本研究表明,黄斑GC - IPL厚度与HCQ使用之间未显示出明确的相关性。然而,一些患者,尤其是患有HCQ视网膜病变或累积剂量高的患者,显示出GC - IPL变薄。