Remolí-Sargues Lidia, Monferrer-Adsuara Clara, López-Salvador Belén, López-Sánchez Enrique, Francés-Muñoz Ester, Castro-Navarro Verónica
Department of Ophthalmology, Hospital Arnau de Vilanova, Valencia, Spain.
Servicio de Oftalmología, Hospital Arnau de Vilanova C/Sant Climent 12, Valencia, 46015, Spain.
Graefes Arch Clin Exp Ophthalmol. 2025 Jul 2. doi: 10.1007/s00417-025-06904-8.
To analyze the choroidal vascularity index (CVI) in patients using hydroxychloroquine (HCQ).
We conducted a retrospective study. The study included 28 healthy patients (56 eyes), 28 patients (56 eyes) using HCQ for 5 years or less (low-risk group), and 22 patients (44 eyes) using HCQ for more than 5 years (high-risk group), all diagnosed with different autoimmune diseases. CVI, total choroidal area (TCA), luminal choroidal area (LCA), stromal choroidal area (SCA), and vessel density (VD) in the choriocapillaris and in the mid choroid, measured using a swept-source optical coherence tomography angiography (SS-OCTA), were registered. In addition, asymmetry index was calculated.
CVI was higher in the high-risk group compared with the control group and the low-risk group (p value < 0,001). In addition, the AI of CVI was lower in the high-risk group compared with the control group (p value 0,042). Regarding SS-OCTA parameters, VD in the mid choroid was lower in the high-risk group compared with the control group (p value 0,001). Correlation analysis revealed a positive correlation between the duration of HCQ therapy and the CVI (r 0,301, p value 0,002), and a negative correlation between HCQ therapy duration and the AI of the TCA, LCA, and SCA (r -0,309, -0,308 and - 0,281, p value 0,027, 0,028 and 0,038, respectively).
We demonstrated a higher CVI in patients on long-term HCQ therapy. Therefore, we suggest that HCQ toxicity may involve the choroid, possibly as a maladaptive vascular response secondary to outer retinal stress induced by the drug.
分析使用羟氯喹（HCQ）患者的脉络膜血管指数（CVI）。
我们进行了一项回顾性研究。该研究纳入了28名健康患者（56只眼）、28名使用HCQ 5年或更短时间的患者（56只眼，低风险组）以及22名使用HCQ超过5年的患者（44只眼，高风险组），所有患者均被诊断患有不同的自身免疫性疾病。使用扫频光学相干断层扫描血管造影（SS - OCTA）测量脉络膜毛细血管和脉络膜中层的CVI、脉络膜总面积（TCA）、脉络膜管腔面积（LCA）、脉络膜基质面积（SCA）和血管密度（VD），并记录不对称指数。
高风险组的CVI高于对照组和低风险组（p值<0.001）。此外，高风险组CVI的不对称指数低于对照组（p值0.042）。关于SS - OCTA参数，高风险组脉络膜中层的VD低于对照组（p值0.001）。相关性分析显示HCQ治疗持续时间与CVI呈正相关（r 0.301，p值0.002），HCQ治疗持续时间与TCA、LCA和SCA的不对称指数呈负相关（r分别为 - 0.309、 - 0.308和 - 0.281，p值分别为0.027、0.028和0.038）。
我们证明长期接受HCQ治疗的患者CVI较高。因此，我们认为HCQ毒性可能累及脉络膜，可能是药物诱导的外视网膜应激继发的适应性血管反应。
