Evaluation of retinal and choroidal microvascular changes in patients who received hydroxychloroquine by optical coherence tomography angiography

Abstract

The aim of the study is to evaluate the retinal and choroidal microvascular changes via optical coherence tomography angiography in patients who received hydroxy chloroquine. Methods: In total, 28 eyes of 28 patients (24 females, and 4 males) receiving treatment with hydroxy chloroquine were assessed in this crosssectional cohort study (hydroxychloroquine group). The highand lowrisk groups consisted of patients receiving hydroxychloroquine for ≥5 years (14 eyes of 28 patients) and <5 years (14 eyes of 28 patients), respectively. A total of 28 age and gendermatched volunteers were enrolled as the control group. The macular flow area (superficial, deep, and choriocapillaris), superficial and deep vessel density, foveal avascular zone area, central foveal thickness, and subfoveal choroidal thickness parameters were measured by optical coherence tomography angiogra phy. Results: The mean age of the 28 patients who received hydroxychloroquine and the 28 agematched controls was 45.5 ± 11.1 years (range: 2970 years) and 44.5 ± 13.9 years (range: 2870 years), respectively. In patients who received hydroxychloroquine, the values for the superficial, deep, and choriocapillaris macular flow areas were 13.578 ± 0.30, 13.196 ± 0.31, and 17.617 ± 0.42, respectively. In controls, these values were 16.407 ± 0.95, 13.857 ± 0.31, and 18.975 ± 0.76, respectively (p<0.05 for all). The superficial, deep, and cho riocapillaris flow areas were significantly smaller in patients who received hydroxychloroquine than those in controls (p<0.05 for all). Superficial and deep vessel densities were significantly reduced in patients who received hydroxychlo roquine in all regions (i.e., foveal, parafoveal, temporal, superior, nasal, and inferior) (p<0.05 for all). Moreover, significant difference was observed between the groups in the foveal avascular zone area (superficial and deep), central foveal thickness, and subfoveal choroidal thickness (p<0.05 for all). Conclusions: Retinochoroidal microvascular flow and vessel density of the macular area were significantly decreased in patients who received hydroxychloroquine. Hy droxychloroquine may damage the retinochoroidal mi cro vascular architecture. Optical coherence tomography angiography may contribute to the early detection of hy dro xychloroquineinduced retinal toxicity.