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Evaluation of Maculopathy in Patients Using Hydroxychloroquine

OBJECTIVES: To determine length of hydroxychloroquine use and cumulative dose and evaluate the ocular effects by 10-2 central visual field test, microperimetry (MP), color fundus photography, optical coherence tomography (OCT), and fundus autofluorescence (FAF) in hydroxychloroquine users. MATERIALS...

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Autores principales: Uğurlu, Adem, Aslanova, Maisa, Cebeci, Zafer, Kır Mercül, Nur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624465/
https://www.ncbi.nlm.nih.gov/pubmed/31245977
http://dx.doi.org/10.4274/tjo.galenos.2018.67864
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author Uğurlu, Adem
Aslanova, Maisa
Cebeci, Zafer
Kır Mercül, Nur
author_facet Uğurlu, Adem
Aslanova, Maisa
Cebeci, Zafer
Kır Mercül, Nur
author_sort Uğurlu, Adem
collection PubMed
description OBJECTIVES: To determine length of hydroxychloroquine use and cumulative dose and evaluate the ocular effects by 10-2 central visual field test, microperimetry (MP), color fundus photography, optical coherence tomography (OCT), and fundus autofluorescence (FAF) in hydroxychloroquine users. MATERIALS AND METHODS: Patients who used hydroxychloroquine continuously for at least 2 years for various connective tissue diseases were included in the study. A total of 300 eyes of 150 patients aged 19-78 years who were followed due to risk of developing hydroxychloroquine maculopathy in the İstanbul University İstanbul Faculty of Medicine Ophthalmology Department between the years 1995-2017 were evaluated. Best corrected visual acuity (BCVA), biomicroscopic, and fundoscopic examination were performed at all visits. MP, FAF, OCT, fundus photography, and central 10-2 visual field examinations were performed 3 times at 6-month intervals. RESULTS: The mean age of patients was 48.9±10.8 years; 141 (94%) patients were female and 9 (6%) were male. The mean duration of hydroxychloroquine use was 10.5±6.4 (2-30) years. Fifty-six patients had been using the drug for 5 years or less. The mean cumulative drug dose was 754.7±447.2 (146-1825) g. Mean BCVA was 0.02±0.08 LogMAR at all follow-up visits (p=0.999). Mean MP values at the first, second, and third examinations were 14.07±3.24 dB, 14.18±3.35 dB, and 14.54±2.79 dB, respectively (p>0.05). Mean central macular thickness was 221.9±19.8 μm at initial examination, 221.8±19.9 μm at the second visit, and 221.8±19.8 μm at the final visit (p=0.113). There was a weak negative correlation between age and MP values at all three visits (visit 1: p=0.003, r=-0.170; visit 2: p=0.001, r=-0.185, visit 3: p=0.011, r=-0.146). There was statistically significant relationship between MP values and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). Duration of use was not associated with changes in 10/2 visual field (p=0.124). There were significant relationships between alterations in FAF and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). CONCLUSION: FAF alterations were significantly associated with duration of hydroxychloroquine use and cumulative dose. As objective methods are more reliable, examinations such as FAF can be recommended as auxiliary methods in the follow-up and early detection of toxic maculopathy.
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spelling pubmed-66244652019-07-17 Evaluation of Maculopathy in Patients Using Hydroxychloroquine Uğurlu, Adem Aslanova, Maisa Cebeci, Zafer Kır Mercül, Nur Turk J Ophthalmol Original Article OBJECTIVES: To determine length of hydroxychloroquine use and cumulative dose and evaluate the ocular effects by 10-2 central visual field test, microperimetry (MP), color fundus photography, optical coherence tomography (OCT), and fundus autofluorescence (FAF) in hydroxychloroquine users. MATERIALS AND METHODS: Patients who used hydroxychloroquine continuously for at least 2 years for various connective tissue diseases were included in the study. A total of 300 eyes of 150 patients aged 19-78 years who were followed due to risk of developing hydroxychloroquine maculopathy in the İstanbul University İstanbul Faculty of Medicine Ophthalmology Department between the years 1995-2017 were evaluated. Best corrected visual acuity (BCVA), biomicroscopic, and fundoscopic examination were performed at all visits. MP, FAF, OCT, fundus photography, and central 10-2 visual field examinations were performed 3 times at 6-month intervals. RESULTS: The mean age of patients was 48.9±10.8 years; 141 (94%) patients were female and 9 (6%) were male. The mean duration of hydroxychloroquine use was 10.5±6.4 (2-30) years. Fifty-six patients had been using the drug for 5 years or less. The mean cumulative drug dose was 754.7±447.2 (146-1825) g. Mean BCVA was 0.02±0.08 LogMAR at all follow-up visits (p=0.999). Mean MP values at the first, second, and third examinations were 14.07±3.24 dB, 14.18±3.35 dB, and 14.54±2.79 dB, respectively (p>0.05). Mean central macular thickness was 221.9±19.8 μm at initial examination, 221.8±19.9 μm at the second visit, and 221.8±19.8 μm at the final visit (p=0.113). There was a weak negative correlation between age and MP values at all three visits (visit 1: p=0.003, r=-0.170; visit 2: p=0.001, r=-0.185, visit 3: p=0.011, r=-0.146). There was statistically significant relationship between MP values and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). Duration of use was not associated with changes in 10/2 visual field (p=0.124). There were significant relationships between alterations in FAF and hydroxychloroquine length of use and cumulative dose (p=0.027 and p=0.049, respectively). CONCLUSION: FAF alterations were significantly associated with duration of hydroxychloroquine use and cumulative dose. As objective methods are more reliable, examinations such as FAF can be recommended as auxiliary methods in the follow-up and early detection of toxic maculopathy. Galenos Publishing 2019-06 2019-06-27 /pmc/articles/PMC6624465/ /pubmed/31245977 http://dx.doi.org/10.4274/tjo.galenos.2018.67864 Text en © Copyright 2019 by Turkish Ophthalmological Association | Turkish Journal of Ophthalmology, published by Galenos Publishing House. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Uğurlu, Adem
Aslanova, Maisa
Cebeci, Zafer
Kır Mercül, Nur
Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title_full Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title_fullStr Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title_full_unstemmed Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title_short Evaluation of Maculopathy in Patients Using Hydroxychloroquine
title_sort evaluation of maculopathy in patients using hydroxychloroquine
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624465/
https://www.ncbi.nlm.nih.gov/pubmed/31245977
http://dx.doi.org/10.4274/tjo.galenos.2018.67864
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