He Shao-Kai, Lai Tso-Ting, Hsieh Yi-Ting
National Taiwan University Hospital, Taipei, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Taiwan J Ophthalmol. 2024 Nov 11;14(4):565-572. doi: 10.4103/tjo.TJO-D-24-00071. eCollection 2024 Oct-Dec.
This study aimed to investigate optical coherence tomography (OCT) characteristics in hydroxychloroquine (HCQ) retinopathy and their correlation with visual acuity among Taiwanese patients.
We retrospectively recruited patients undergoing long-term HCQ treatment who had received examinations of best-corrected visual acuity and OCT scans. We observed disruptions in the ellipsoid zone (EZ) and retinal pigment epithelium (RPE) across different retinal regions. Principal component analysis (PCA) was employed to identify the most significant factors associated with visual deterioration.
Among the 120 eyes included in the study, HCQ retinopathy was present in 42 eyes (35.0%). In patients with mild-to-moderate retinopathy, the pericentral pattern was predominant (75.0%), whereas no parafoveal pattern was observed. Serial examinations revealed that lesions typically progressed from pericentral to parafoveal and foveal regions. EZ disruption was observed in all affected cases, most frequently at the pericentral region (100%), followed by the perifoveal (87.4%), parafoveal (72.1%), and foveal (43.2%) regions. RPE disruption was noted in 59.5% of cases, with the highest prevalence at the pericentral (53.2%) and perifoveal (52.3%) regions, followed by the parafoveal (33.3%) and foveal (28.8%) regions. PCA identified RPE disruption at the fovea and parafoveal regions as the most strongly correlated factors for visual deterioration.
In Taiwanese patients, HCQ retinopathy predominantly manifests with pericentral lesions, while isolated parafoveal lesions are rare as an initial presentation. RPE disruption, rather than EZ disruption, appears to be the primary determinant for visual deterioration in this population.
本研究旨在调查台湾地区患者羟氯喹（HCQ）视网膜病变的光学相干断层扫描（OCT）特征及其与视力的相关性。
我们回顾性招募了接受长期HCQ治疗且接受过最佳矫正视力检查和OCT扫描的患者。我们观察了不同视网膜区域的椭圆体带（EZ）和视网膜色素上皮（RPE）的破坏情况。采用主成分分析（PCA）来确定与视力下降相关的最重要因素。
在纳入研究的120只眼中，42只眼（35.0%）存在HCQ视网膜病变。在轻度至中度视网膜病变患者中，中心周围型为主（75.0%），而未观察到黄斑旁型。系列检查显示，病变通常从中心周围进展至黄斑旁和黄斑区。在所有受影响病例中均观察到EZ破坏，最常见于中心周围区域（100%），其次是黄斑周围（87.4%）、黄斑旁（72.1%）和黄斑（43.2%）区域。59.5%的病例中发现RPE破坏，在中心周围（53.2%）和黄斑周围（52.3%）区域患病率最高，其次是黄斑旁（33.3%）和黄斑（28.8%）区域。PCA确定黄斑和黄斑旁区域的RPE破坏是与视力下降最密切相关的因素。
在台湾地区患者中，HCQ视网膜病变主要表现为中心周围病变，而孤立的黄斑旁病变作为初始表现较为罕见。RPE破坏而非EZ破坏似乎是该人群视力下降的主要决定因素。
