Ozek Dilay, Onen Mehmet, Karaca Emine Esra, Omma Ahmet, Kemer Ozlem Evren, Coskun Cigdem
Department of Ophthalmology, Health Sciences University, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Rheumatology, Health Sciences University, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Eur J Ophthalmol. 2019 Sep;29(5):532-537. doi: 10.1177/1120672118801125. Epub 2018 Sep 19.
The aim of this study is to measure retinal vessel density and thickness of the macula by optical coherence tomography angiography in patients with rheumatoid arthritis taking hydroxychloroquine.
The study included 40 patients with rheumatoid arthritis taking hydroxychloroquine and 20 age-, gender-, and axial length-matched control subjects. Patients were divided into two groups according to the duration of hydroxychloroquine use. Twenty four of the patients were taking hydroxychloroquine for more than 5 years (Group 1), and the rest of 16 were taking hydroxychloroquine for less than 5 years (Group 2). A total of 20 age- and gender-matched volunteers with similar axial length were selected as Group 3. All of the patients underwent optical coherence tomography angiography, and 3 mm × 3 mm scanning mode was chosen for analyzing vascular density and morphological characteristics on the choriocapillaris layer. In addition, Humphrey visual field 10-2 was evaluated in each subject.
The temporal deep vascular density was measured as 48.13% ± 8.5% in Group 1, 54.42% ± 10.3% in Group 2, and 60.35% ± 13.1% in Group 3. Deep temporal and deep hemi-inferior vascular density was significantly lower in Group 1 in comparison with Group 3 (p = 0.041 and p = 0.046, respectively). Visual field testing was normal in all patients.
The optical coherence tomography angiography findings showed that the parafoveal deep temporal and deep hemi-inferior vascular plexus density was reduced in patients taking hydroxychloroquine for more than 5 years despite having normal perimetry. This observation, which can be obtained only through optical coherence tomography angiography, may be relevant to the early findings of hydroxychloroquine toxicity.
本研究旨在通过光学相干断层扫描血管造影术测量服用羟氯喹的类风湿性关节炎患者的视网膜血管密度和黄斑厚度。
本研究纳入40例服用羟氯喹的类风湿性关节炎患者以及20例年龄、性别和眼轴长度匹配的对照受试者。根据羟氯喹的使用时长将患者分为两组。24例患者服用羟氯喹超过5年（第1组），其余16例服用羟氯喹少于5年（第2组）。另外选取20例年龄和性别匹配、眼轴长度相近的志愿者作为第3组。所有患者均接受光学相干断层扫描血管造影术检查，并选择3mm×3mm扫描模式分析脉络膜毛细血管层的血管密度和形态特征。此外，对每位受试者进行Humphrey视野10-2检测。
第1组颞侧深层血管密度为48.13%±8.5%，第2组为54.42%±10.3%，第3组为60.35%±13.1%。与第3组相比，第1组颞侧深层和半下方深层血管密度显著降低（分别为p = 0.041和p = 0.046）。所有患者的视野检测均正常。
光学相干断层扫描血管造影术结果显示，尽管视野检测正常，但服用羟氯喹超过5年的患者黄斑旁颞侧深层和半下方深层血管丛密度降低。这一仅通过光学相干断层扫描血管造影术获得的观察结果可能与羟氯喹毒性的早期表现有关。
