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VOLUMETRIC SINGLE-LAYER INNER RETINAL ANALYSIS IN PATIENTS WITH HYDROXYCHLOROQUINE TOXICITY
Yasha S Modi1, Adrian Au, Vishal S Parikh
1*Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and †Case Western Reserve School of Medicine, Cleveland, Ohio.
Retina (Philadelphia, Pa.)
|June 4, 2016
Summary
Hydroxychloroquine (HCQ) toxicity causes significant thinning in both inner and outer retinal layers. This volumetric loss is evident compared to patients taking HCQ without toxicity and healthy controls.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Toxicology
Background:
- Hydroxychloroquine (HCQ) is a medication used to treat autoimmune diseases.
- Ocular toxicity from HCQ can lead to irreversible vision loss.
- Early detection of HCQ retinopathy is crucial for preserving vision.
Purpose of the Study:
- To compare retinal layer volumes in patients with HCQ toxicity versus control groups.
- To assess volumetric changes in specific retinal layers using spectral-domain optical coherence tomography (SD-OCT).
Main Methods:
- Volumetric analysis of macular cube scans was performed using a validated algorithm.
- Retinal layers analyzed included the ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer retina (OPL to RPE).
- Three groups were compared: HCQ toxicity, HCQ exposure without toxicity, and age-matched controls.
Main Results:
- Significant reductions in ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer retina volumes were observed in HCQ toxicity eyes.
- No significant volume differences were found between HCQ exposure (without toxicity) and control groups.
- Increasing HCQ retinopathy severity correlated with greater inner retinal volume loss.
Conclusions:
- HCQ toxicity is associated with volumetric thinning in both outer and inner retinal layers.
- Retinal layer volume analysis can help identify HCQ-induced toxicity.
- Findings suggest HCQ affects multiple retinal layers beyond the typically recognized outer retina.
