The effect of long-term hydroxychloroquine use on the corneal endothelium in patients with systemic lupus erythematosus

Vural, Esra; Hazar, Leyla; Erol, Kemal

doi:10.1007/s10792-020-01649-1

Cited by 1 publication

(1 citation statement)

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“…In most cases, corneal deposits are reversible on drug discontinuation [18]. In addition, previous studies have reported decreased corneal endothelial cell density, increased central corneal thickness, and other changes in corneal parameters in patients with long-term HCQ use [24][25][26]. Our results also showed decreased corneal endothelial cell density and increased central corneal thickness in the HCQ treatment group, although they were not statistically significant.…”

Section: Discussioncontrasting

confidence: 54%

Evaluation of Corneal and Retinal Toxicity in Rheumatoid Arthritis Patients Treated with Hydroxychloroquine

et al. 2022

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Introduction: To assess the ocular toxicity of hydroxychloroquine (HCQ) by confocal microscopy, multifocal electroretinography (mfERG), and scanning laser polarimetry with variable corneal compensation (GDxVCC) in patients with rheumatoid arthritis (RA). Methods: A cross-sectional, comparative case series study was retrospectively conducted on 61 patients under HCQ treatment for RA without fundoscopic anomalies (Group 1), 65 RA patients with no HCQ treatment (Group 2), and 27 normal subjects (Group 3). A comprehensive ophthalmological examination, including confocal microscopy, mfERG, and GDxVCC, was performed in the three groups. Results: In Group 1, the duration of treatment ranged from 19 to 96 months (54.9 ± 15.2 months). The mean cumulative dose of HCQ was 446.1 ± 164.0 g (range 114 - 864 g). Confocal microscopy revealed hyper-reflective abnormal particles in 45 patients (73.8%) and beaded, tortuous fibres in 34 patients (55.7%) in group 1. No corneal change was observed in the other two groups. The mfERG responses in the 6 concentric rings (R1 - R6) among the three groups differed except at R3 (all P < 0.05), and data from R1 - R6 were not significantly different between Groups 2 and 3. The retinal nerve fibre layer (RNFL) thicknesses were statistically thinner in Group 1 than in Groups 2 and 3 (all P < 0.05). Conclusions: Early signs of corneal and neural retina structure changes were detected in patients with RA treated with hydroxychloroquine. Whether these findings should be a mark of drug recession still needs further study and more evidence.

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