羟氯喹治疗患者的光学相干断层扫描血管造影参数评估。
Evaluation of optical coherence tomography angiography parameters in patients treated with Hydroxychloroquine.
机构信息
Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Science, Isfahan, Iran.
出版信息
BMC Ophthalmol. 2021 May 11;21(1):209. doi: 10.1186/s12886-021-01977-5.
BACKGROUND
One of the major side effects of Hydroxychloroquine (HCQ) is retinopathy. The aim of this study was to evaluate the Optical coherence tomography angiography (OCTA) parameters in a group of patients who have Hydroxychloroquine-induced retinopathy based on Multifocal electroretinography (mfERG) with a group who do not have retinopathy.
METHOD
This is a Cross-Sectional Study. In this study, patients with Rheumatoid arthritis (RA) or Systemic lupus erythematosus (SLE) who had been taking Hydroxychloroquine for at least 7 years were included. MfERG and OCTA imaging were performed for all patients. Patients were divided into Normal mfERG and Abnormal mfERG groups based on mfERG results. OCTA parameters were studied in these two groups.
RESULT
Sixty-one patients (61 eyes) were included. Forty-one patients had SLE and 20 patients had RA. Forty patients (66.7%) had Abnormal mfERG. The mean vascular density (VD) in Superficial capillary plexus (SCP) layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). Mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). In RA subgroup, mean VD in SCP layer in PeriFovea region in Abnormal mfERG group was significantly lower than normal group (P-Value < 0.05). Mean VD in deep capillary plexus (DCP) layer in Whole Image, Superior Hemi, Inferior Hemi, PeriFovea area in Abnormal mfERG group was significantly lower than normal group (P-Value < 0.05). This discrepancy was also observed in the RA subgroup but not in the SLE subgroup. The mean of none of the parameters of foveal avascular zone (FAZ) (mm2), Flow Area of Outer Retina (mm2) and Flow Area of Choriocapillaris (mm2) were not statistically significant between the groups Abnormal mfERG and Normal mfERG. (p-value> 0.05).
CONCLUSION
VD in the DCP layer decreased in abnormal mfERG patients compared to patients with normal mfERG. But it seems that VD in SCP layer, FAZ Area and Flow Area are similar in both groups. OCTA may be used as a non-invasive tool in the diagnosis of early stages of HCQ-induced retinopathy, especially in RA patients, but further studies are needed.
背景
羟氯喹（HCQ）的主要副作用之一是视网膜病变。本研究的目的是通过多焦视网膜电图（mfERG）评估一组患有 HCQ 诱导性视网膜病变的患者的光学相干断层扫描血管造影（OCTA）参数，并与一组无视网膜病变的患者进行比较。
方法
这是一项横断面研究。本研究纳入了类风湿关节炎（RA）或系统性红斑狼疮（SLE）患者，这些患者已服用 HCQ 至少 7 年。对所有患者进行 mfERG 和 OCTA 成像。根据 mfERG 结果，将患者分为正常 mfERG 和异常 mfERG 组。研究这两组的 OCTA 参数。
结果
共纳入 61 名患者（61 只眼）。其中 41 例为 SLE，20 例为 RA。40 例（66.7%）患者的 mfERG 异常。在浅层毛细血管丛（SCP）层中，正常 mfERG 组和异常 mfERG 组之间的平均血管密度（VD）无显著差异（P 值>0.05）。SCP 层的平均 VD 在正常 mfERG 组和异常 mfERG 组之间无显著差异（P 值>0.05）。在 RA 亚组中，异常 mfERG 组的 PeriFovea 区域 SCP 层的平均 VD 明显低于正常组（P 值<0.05）。在异常 mfERG 组中，整个图像、上半部分、下半部分、PeriFovea 区域的深层毛细血管丛（DCP）层的平均 VD 明显低于正常组（P 值<0.05）。这种差异在 RA 亚组中也观察到，但在 SLE 亚组中未观察到。黄斑无血管区（FAZ）（mm2）、外视网膜血流面积（mm2）和脉络膜毛细血管血流面积（mm2）的各参数平均值在异常 mfERG 组和正常 mfERG 组之间均无统计学意义（p 值>0.05）。
结论
与正常 mfERG 患者相比，异常 mfERG 患者的 DCP 层的 VD 降低。但 SCP 层、FAZ 区域和血流面积的 VD 在两组中似乎相似。OCTA 可作为诊断 HCQ 诱导性视网膜病变早期阶段的非侵入性工具，特别是在 RA 患者中，但需要进一步研究。
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