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Evaluation of early retinal changes in patients on long-term hydroxychloroquine using optical coherence tomography

Huanhuan Zhao1,2, Menglu Pan1, Yaping Liu3,4

  • 1Department of Rheumatology, First Affiliated Hospital of Anhui Medical University, Hefei, China.

Therapeutic Advances in Drug Safety
|February 1, 2024
PubMed

Insights

Long-term hydroxychloroquine (HCQ) use in connective tissue diseases (CTD) correlates with retinal vascular changes, detectable by OCTA. However, HCQ concentrations in blood did not show a direct association with these OCTA-measured retinal changes.

Area of Science:

  • Ophthalmology
  • Rheumatology
  • Pharmacology

Background:

  • Connective tissue diseases (CTD), such as lupus and rheumatoid arthritis, are often treated with hydroxychloroquine (HCQ).
  • Prolonged HCQ use can lead to adverse effects, notably retinopathy, necessitating monitoring for early detection of retinal changes.

Purpose of the Study:

  • To identify early retinal alterations using optical coherence tomography angiography (OCTA) in CTD patients undergoing long-term HCQ treatment.
  • To investigate the correlation between OCTA parameters and serum concentrations of HCQ and its metabolites.

Main Methods:

  • A cross-sectional study involved 43 CTD patients treated with HCQ for over 6 months.
  • OCTA was used to measure foveal avascular zone (FAZ) dimensions, macular thickness, and vascular density in the superficial (SCP) and deep (DCP) capillary plexuses.
  • Serum concentrations of HCQ and its metabolites were quantified using high-performance liquid chromatography-tandem mass spectrometry.

Main Results:

  • Cumulative HCQ duration and dose positively correlated with increased FAZ area and perimeter, and negatively with foveal vessel density in both SCP and DCP.
  • No significant correlation was found between OCTA findings and patient age, disease duration, or weight-adjusted HCQ dose.
  • OCTA outcomes did not correlate with measured blood concentrations of HCQ or its metabolites.

Conclusions:

  • OCTA is a valuable tool for detecting microvascular changes in the macula of CTD patients on long-term HCQ therapy.
  • Current findings suggest that serum concentrations of HCQ and its metabolites are not directly associated with the observed retinal vascular changes.
Abstract

Keywords:
blood concentrationhydroxychloroquineoptical coherence tomography angiographyretinopathy

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