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Early morpho-functional changes in patients treated with hydroxychloroquine: a prospective cohort study
Giulio Ruberto1, Carlo Bruttini2, Carmine Tinelli3
1Ophthalmic Clinic, San Matteo Hospital, viale Golgi 19, 27100, Pavia, Italy. rubertog@smatteo.pv.it.
Hydroxychloroquine (HCQ) treatment can cause early retinal changes. Multifocal electroretinograms (mfERGs) and spectral-domain optical coherence tomography (SD-OCT) detected these alterations before significant vision loss occurred in patients with rheumatic diseases.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is a common medication for rheumatic diseases.
- HCQ can cause retinal toxicity, necessitating regular monitoring.
- Early detection of retinal changes is crucial for preventing vision loss.
Purpose of the Study:
- To identify early morphological and functional retinal alterations in patients treated with HCQ.
- To assess the utility of mfERG and SD-OCT in detecting subclinical retinopathy.
Main Methods:
- Prospective cohort study of 33 patients with rheumatic diseases on HCQ.
- Control group of 28 healthy subjects.
- Comprehensive eye examinations including mfERG, SD-OCT, BCVA, FAF, 10-2 VF, and FDT.
Main Results:
- Reduced mfERG P1 wave density amplitudes in all retinal rings (p<0.001).
- Significant retinal thinning detected by SD-OCT in multiple sectors.
- Minimal fundus autofluorescence alterations observed in 8 eyes.
Conclusions:
- mfERG and SD-OCT reveal functional and morphological retinal alterations in HCQ-treated patients.
- These changes occur before significant clinical retinopathy is evident.
- mfERG and SD-OCT are valuable tools for early detection of HCQ retinopathy.
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