In the absence of clinically apparent foveal toxicity, CFT, SFCT together with ring amplitude ratio could be used as good predictors of subclinical nicotine induced foveal changes.

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Aim. To evaluate the possible structural and functional changes in the retinal nerve fibre layer (RNFL) and the ganglion cell complex (GCC) of chronic smokers and compare them with those of passive healthy smokers using spectral domain optical coherence tomography (SD-OCT) and pattern electroretinogram (PERG). Materials and Methods. We include 80 active chronic smokers and 80 age- and sex-matched healthy passive smokers. After a full ophthalmological examination, SD-OCT and PERG were tested for all participants. Urinary levels of cotinine and creatinine with subsequent calculation of the cotinine creatinine ratio (CCR). Results. Inferior and superior quadrants of RNFL were thinner in group I, but nasal and temporal quadrants did not show significant difference between the groups. There were no significant differences of GCC values between the two groups. There was no significant difference of PERG-P50 amplitude and latency; however, PERG-N95 showed significant difference between the two groups. Multiple regression analyses demonstrated that the number of cigarettes/day, urinary cotinine, and PERG-N95 amplitude are the most important determinants for both superior and inferior RNFL thicknesses. Conclusion. RNFL thickness decreases in chronic, healthy, heavy cigarette smokers, and this thinning is related to the number of cigarettes/day, urinary cotinine, and PERG-N95 latency and amplitude.

Background:The patients with early retinopathy can be asymptomatic with normal fundus before any signs of maculopathy appear; hence, screening for early detection in the premaculopathy stage is recommended. Spectral domain optical coherence tomography (SD-OCT) detects early structural damage to macula in patients on hydroxychloroquine (HCQ) therapy. Aim of the work:To evaluate the role of spectral-domain optical coherence tomography (SD-OCT) in early detection of hydroxylchloroquine (HCQ) maculopathy. Patients and methods: This cross-sectional observational study was conducted between November 2017 and November 2019 on 100 adult female patients taking HCQ referred from the ophthalmology and rheumatology outpatient clinics of Ain Shams UniversityHospital. The age of the participants ranged between 25 and 60 years. Fifty age and sex matched healthy subjects were assessed as a control group. The study was conducted in accordance with the ethical standards stated in the Faculty of Medicine -Ain Shams University, with informed consent obtained. Results:The mean central foveal thickness was found to be thinner in the hydroxychloroquine group than the normal controls, which was statistically significant (p value = 0.042). The upper, lower, nasal and temporal parafoveal thickness were thinner in the hydroxychloroquine group in comparison to that of the control group (p value = 0.001, 0.020, 0.001 & 0.001 respectively). The upper, temporal and lower perifoveal thickness showed statistically significant thinning in the hydroxychloroquine group (p value = 0.002, < 0.001 & 0.041 respectively) in all quadrants except the nasal quadrant which was not statistically significant (p = 0.169). No significant difference was detected between the two groups regarding ganglion cell complex thickness. Conclusion: Preclinical hydroxychloroquine toxicity can lead toearly thinning in the central fovea as well as the parafoveal and perifoveal regions that is detected by SD-OCT.

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