Corneal thickness and endothelial changes in long-term hydroxychloroquine use.

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Hydroxychloroquine (HCQ) is widely prescribed for rheumatologic conditions.
• Long-term use may lead to ocular toxicity, including corneal changes.
• Monitoring corneal health is crucial for patients on HCQ therapy.

Purpose of the Study:

• To investigate the association between long-term HCQ use (≥3 years) and specific corneal parameters.
• To compare corneal endothelial cell density (ECD), central corneal thickness (CCT), cell size variation (CV), and hexagonal cell percentage (HEX%) between HCQ users and controls.

Main Methods:

• A comparative study involving 62 patients on long-term HCQ for rheumatologic diseases and 62 healthy controls.
• Corneal assessments included CCT, ECD, CV, and HEX%.
• Data collected during HCQ retinal toxicity screening.

Main Results:

• Patients on long-term HCQ exhibited significantly lower mean ECD (2742 cells/mm²) compared to controls (2875 cells/mm²; p=0.01).
• Mean CCT was significantly higher in the HCQ group (567.05 µm) versus controls (540.15 µm; p<0.001).
• No significant differences were found in CV or HEX% between the groups (p>0.05).

Conclusions:

• Long-term HCQ use is linked to reduced corneal endothelial cell density and increased central corneal thickness.
• Corneal endothelial cell morphology (CV and HEX%) does not appear significantly altered by long-term HCQ.
• These findings highlight potential structural corneal changes associated with HCQ therapy.