Hasan Nasiq, Driban Matthew, Mohammed Abdul Rasheed, Schwarz Swen, Yoosuf Shakira, Barthelmes Daniel, Vupparaboina Kiran Kumar, Al-Sheikh Mayss, Chhablani Jay
Dr. Agarwal's Eye Hospital, Tirunelveli, Tamil Nadu, India.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Eye (Lond). 2024 Feb;38(3):620-624. doi: 10.1038/s41433-023-02747-x. Epub 2023 Sep 28.
To determine changes in choroidal volume (CV) and choroidal vascularity index (CVI) in patients on hydroxychloroquine (HCQ) therapy.
Retrospective analysis of patients on HCQ therapy. CV and CVI were assessed below the central foveal region on spectral-domain optical coherence tomography using an automatic denoising and localization algorithm. CV and CVI were compared with age-matched controls. Regression analyses were performed to generate associations between CV and CVI with demographics and HCQ treatment parameters. Associations were assessed using a generalized estimating equation model adjusted for intra-subject inter-eye correlations.
A total of 137 adult patients (23 males and 114 females) were included. Mean age was 45.6 ± 13.7 years and most patients identified as Caucasian (79%). Total duration of HCQ therapy ranged from 3 months to 20 years. Daily HCQ intake varied from 150-600 mg (mean = 304 mg), while cumulative doses ranged from 18-2,800 g. At presentation, the median CV was 0.51 (IQR:0.356-0.747) mm, and median CVI was 0.559 (IQR:0.528-0.578). Increased cumulative HCQ dose was associated with decreased CV (p = 0.006). Compared to age-matched controls, CV, CVI, and luminal area were significantly lower in the study group (p = 0.0003, 0.0001, and 0.0002).
In this study, we present a novel analysis of key biomarkers which predate the occurrence of HCQ retinopathy. Choroidal volume and vascularity index are significantly reduced in patients on HCQ therapy, especially at higher cumulative doses. These findings suggest new tools to guide medical decision-making for patients receiving HCQ therapy for rheumatologic diseases.
确定接受羟氯喹（HCQ）治疗的患者脉络膜体积（CV）和脉络膜血管指数（CVI）的变化。
对接受HCQ治疗的患者进行回顾性分析。使用自动去噪和定位算法在谱域光学相干断层扫描上评估中央凹区域下方的CV和CVI。将CV和CVI与年龄匹配的对照组进行比较。进行回归分析以生成CV和CVI与人口统计学和HCQ治疗参数之间的关联。使用针对受试者内眼间相关性进行调整的广义估计方程模型评估关联。
共纳入137例成年患者（23例男性和114例女性）。平均年龄为45.6±13.7岁，大多数患者为白种人（79%）。HCQ治疗的总持续时间为3个月至20年。每日HCQ摄入量为150 - 600mg（平均 = 304mg），而累积剂量为18 - 2800g。就诊时，CV中位数为0.51（四分位间距：0.356 - 0.747）mm，CVI中位数为0.559（四分位间距：0.528 - 0.578）。累积HCQ剂量增加与CV降低相关（p = 0.006）。与年龄匹配的对照组相比，研究组的CV、CVI和管腔面积显著更低（p = 0.0003、0.0001和0.0002）。
在本研究中，我们对早于HCQ视网膜病变发生的关键生物标志物进行了新的分析。接受HCQ治疗的患者脉络膜体积和血管指数显著降低，尤其是在累积剂量较高时。这些发现提示了新的工具，可用于指导接受HCQ治疗的风湿性疾病患者的医疗决策。
