Halouani Safa, Le Hoang Mai, Querques Giuseppe, Borrelli Enrico, Sacconi Riccardo, Battista Marco, Jung Camille, Souied Eric H, Miere Alexandra
Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, University Vita-Salute San Raffaele, Milan Italy; and.
Retina. 2023 Jan 1;43(1):94-101. doi: 10.1097/IAE.0000000000003638.
To investigate choroidal involvement in eyes of patients treated with hydroxychloroquine (HCQ), by quantifying the choroidal vascularity index (CVI) and other choroidal biomarkers.
Vertical enhanced depth imaging spectral domain optical coherence tomography (SD-OCT) scans were performed in eyes with either advanced-stage or mild HCQ toxic retinopathy, as well as in healthy age-matched and sex-matched controls. Based on SD-OCT scans, the subfoveal and mean choroidal thickness (ChT) was measured. The CVI, total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA) were calculated based on a binarization image process. These variables were computed and compared between the three groups (i.e., advanced stage, mild toxicity, and healthy controls).
Forty-eight eyes of 47 patients under HCQ (26 eyes presented with advanced stage HCQ toxicity and 22 eyes with mild toxicity) and 34 eyes of 31 healthy controls were included. Both CVI and ChT were significantly different between the three groups ( P < 0.001, P < 0.001). When comparing the advanced stage toxicity group to healthy controls, both the subfoveal and the mean ChT were diminished ( P < 0.001). The CVI, TCA, LCA, and SCA were significantly lower in the advanced stage of toxicity group when compared with controls ( P < 0.001, <0.00001, <0.0001, and P = 0.0094, respectively).
Our study suggests that eyes with HCQ toxic retinopathy, especially at advanced stages, present with choroidal impairment, giving further pathophysiological insights into the unfolding of this retinal toxicity.
通过量化脉络膜血管指数（CVI）和其他脉络膜生物标志物，研究接受羟氯喹（HCQ）治疗的患者眼部的脉络膜受累情况。
对患有晚期或轻度HCQ毒性视网膜病变的眼睛，以及年龄和性别匹配的健康对照者的眼睛进行垂直增强深度成像光谱域光学相干断层扫描（SD-OCT）。基于SD-OCT扫描，测量黄斑中心凹下和平均脉络膜厚度（ChT）。基于二值化图像处理计算CVI、脉络膜总面积（TCA）、脉络膜管腔面积（LCA）和脉络膜基质面积（SCA）。计算并比较三组（即晚期、轻度毒性和健康对照）之间的这些变量。
纳入了47例接受HCQ治疗患者的48只眼（26只眼呈现晚期HCQ毒性，22只眼呈现轻度毒性）和31名健康对照者的34只眼。三组之间的CVI和ChT均有显著差异（P<0.001，P<0.001）。将晚期毒性组与健康对照相比，黄斑中心凹下和平均ChT均降低（P<0.001）。与对照组相比，毒性晚期组的CVI、TCA、LCA和SCA显著降低（分别为P<0.001、<0.00001、<0.0001和P=0.0094）。
我们的研究表明，患有HCQ毒性视网膜病变的眼睛，尤其是晚期，存在脉络膜损伤，这为这种视网膜毒性的发生发展提供了进一步的病理生理学见解。
