Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

Abstract

Purpose To detect the early changes in retinal vasculature via optical coherence tomography angiography (OCTA) by comparing the quantitative OCTA parameters in the group of patients who were using hydroxychloroquine (HCQ) or not. Methods This was a cross-sectional, comparative, and observational study. The patients who were newly or previously prescribed HCQ for an autoimmune disease were included. OCTA imaging was performed via OCT RT XR Avanti with AngioVue software (Optivue Inc, Freemont, CA). The study group had two groups: a control group (patients newly diagnosed and who were not taking any medication) and a treatment group (patients who were receiving HCQ treatment). The main outcome measure was OCTA parameters. Results A total of 102 eyes of 102 patients were included. There were 70 patients in the treatment group and 32 patients in the control group. All of the vascular density values were similar between the control and treatment groups (p [ 0.05 for all). However, the superficial whole thickness, superficial parafoveal thickness, superficial perifoveal thickness, deep whole thickness, deep parafoveal thickness, and deep perifoveal thickness were thinner in the treatment group than the control group (p \ 0.05 for all). Conclusion Vascular density parameters did not differ between the control and treatment groups. However, the retinal thickness values were lower in the treatment group.

Evaluation of optical coherence tomography angiography parameters in patients treated with Hydroxychloroquine

“…To the best of our knowledge, limited studies have been conducted on the use of OCTA in the evaluation of HCQ-induced retinopathy, the results of which are also controversial. Some studies have evaluated OCTA changes between healthy individuals and patients with a history of HCQ use, and some studies have evaluated OCTA changes between High Risk (HCQ users over 5 years) and Low Risk (HCQ users less than 5 years) [ 22 , 23 , 28 , 30 – 32 ]. A review of studies in this field shows confusing results.…”

“…In the study of Tarakcioglu et al, which was performed among 102 patients, No significant difference was observed between the HCQ treatment group and the control group in the parameters of FAZ, Flow Area, vascular density, SCP and DCP [ 28 ]. Based on our results, the patients in both groups were similar in the parameters of FAZ, Flow Area and SCP vascular density.…”

“…And quantitative values of vascular density (in superficial retinal capillary plexus (SCP) and deep capillary plexus (DCP)), foveal avascular zone (FAZ), Flow Rate (in choriocapillaris, outer retina layers) and Retinal Thickness automatically by the software was calculated. Images with signal strength index (SSI) less than 40 or had an artifact were not analyzed [ 28 ]. Finally, based on mfERG criteria, we divided patients into normal mfERG and abnormal mfERG groups.…”

Evaluation of optical coherence tomography angiography parameters in patients treated with hydroxychloroquine

“…Some studies have evaluated OCTA changes between healthy individuals and patients with a history of HCQ use, and some studies have evaluated OCTA changes between High Risk (HCQ users over 5 years) and Low Risk (HCQ users less than 5 years). (22,23,28,(30)(31)(32) A review of studies in this eld shows confusing results. To our knowledge, no study has been performed to evaluate changes in OCTA among patients with HCQ-induced retinopathy based on mfERG and those without retinopathy.…”

“…Images with signal strength index (SSI) less than 40 or had an artifact were not analyzed. (28)Finally, based on mfERG criteria, we divided patients into normal mfERG and abnormal mfERG groups. We also divided patients into separate SLE and RA subgroups.…”