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Corneal thickness and endothelial changes in long-term hydroxychloroquine use

Tevfik Oğurel1, Murat Atabey Özer2, Yaprak Akbulut1

  • 1a Department of Ophthalmology, Medical Faculty, Kırıkkale University , Kırıkkale , Turkey.

Cutaneous and Ocular Toxicology
|April 24, 2019
PubMed

Insights

Long-term hydroxychloroquine (HCQ) use in rheumatologic patients is associated with significant corneal changes. Specifically, patients showed decreased corneal endothelial cell density and increased central corneal thickness compared to controls.

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.

Keywords:
Hydroxychloroquinecorneal thicknessendothelial cell density

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