Peripapillary microvascular changes in long-term hydroxychloroquine users: Quantitative analysis using optical coherence tomography angiography

Author: Slim Salmi (Tunisia)

Co-authors: Asma Khallouli, Rahma Saidane, Racem Choura, Ahmed Arfaoui, Afef Maalej, Riadh Rannen

Purpose

To evaluate changes in the peripapillary vascular network s using spectral-domain optical coherence tomography Angiography (SD-OCTA) in hydroxychloroquine (HCQ) users.

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

Twenty-five eyes of 25 patients and 25 eyes of 25 age matched healthy controls were enrolled.All subjects underwent a history taken about HCQ use ( duration,cumulative dose,diagnosis) and comprehensive ocular examinations, including measurement of best-corrected visual acuity (BCVA), biomicroscopy and examination of the fundus. OCTA scans were performed using Angiovue software of the RTVue XR Avanti. A 4.5 × 4.5 mm images for the Radial Peripapillary Capillaries (RPC) were obtained. Retinal Fiber Layer (RNFL) thickness, whole image (wi), inside disc (id) and peripapillary (pp) were evaluated in both groups.

Results

The mean age was 41.73 ± 1.27 years in HCQ users group and 38.00 ± 12 years in healthy controls group (p= 0.243). The mean duration of HCQ usage was 63.6 ± 38.4 months, and the cumulative dose of HCQ was 528.1 ± 3.44 g. Four patients developed HCQ retinopathy. Compared to the control group, there was no significant difference in peripapillary vascular densities (wi, id, pp) (all p>0.05). RNFL thicknesses of the HCQ users did not significantly decrease compared to those of the normal controls. No significant correlation was found between the RNFL thickness and the duration of use or cumulative dose.

Conlusions

The peripapillary microvasculature and RNFL thicknesses did not change in the HCQ users. RNFL thickness is not a useful biomarker for the early detection of HCQ retinal toxicity.

Financial Disclosure

The authors declare no conflict of interest.