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UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS Guest
2024-11-23 17:40 |
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Conference: Bucharest University Faculty of Physics 2016 Meeting
Section: Biophysics; Medical Physics
Title:
Optical Coherence Tomography in Early Diagnosis of Hydroxycloroquine Maculopathies
Authors:
Aida GEAMANU (1), Ancuţa Elena BACIU (2), Claudia Gabriela CHILOM (3), Alina POPA-CHERECHEANU (1)
Affiliation:
1) University of Medicine and Pharmacy "Carol Davila" Bucharest
2) National Institute of Endocrinology "C. I. Parhon", Bucharest, Romania
3) University of Bucharest, Faculty of Physics, Romania
E-mail
ancutaelenabaciu@yahoo.com
Keywords:
Optical coherence tomography, hydroxychloroquine, maculopathies, retinal toxicity.
Abstract:
The purpose of this study is the elective treatment of patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) under medication. One of the most commonly used drugs is hydroxychloroquine sulfate (HCQ), which aims to reduce the inflammation in the affected joints and organs. The goal is to put in evidence the early toxic effects of HCQ chronical exposure before the changes of visual acuity, using optical coherence tomography (SD-OCT), a modern imaging method. This study includes analysis of 60 female subjects with SLE and RA with a history of HCQ exposure for at least 5 years and 30 subjects without exposure to HCQ. They were classified into three groups: group I (22 subjects) with changes regarding the opthalmoscopic hydroxychloroquine retinotoxicity; group II (38 subjects) with no changes in the ophthalmoscope examination, and group III (control) of subjects with no history of HCQ exposure. Each group was examined to both eyes and statistical evaluation was taken into account. The most affected eyes were in groups I and II. The statistical analysis of the control group was performed on 30 cases (right eye). SD-OCT analysis was performed in the Clinic of Ophthalmology at the University Hospital in Bucharest. The average age in the three groups analyzed was about 48 years with 52 patients with SLE and 8 patients with RA with an exposure to HCQ between 5 and 17 years. SD-OCT analysis, correlated with the duration of exposure and the daily administered dose, showed an exceeding of the recommended daily dose (> 6.5 mg kg/day) depending on body mass index (BMI) in a significant number of cases (50 %) and maculopathy or early “bull's eye". Also, the correlation between height of the patients in group I and II revealed that the risk of retinotoxicity appears most often in people under 1.7 m. The SD-OCT analysis showed a thinning of the nerve fiber layer, observed in groups I and II as compared to control (p = 0.021 vs group III, group I and group I, p = 0.001 vs group III). Quantitative analysis of the macular region of group I showed a reduction in macular thickness in all areas of interest being statistically significant (p < 0.05), underscoring the toxic effects of HCQ. In group II only a perifoveal thinning area was put in evidenced (p = 0.009). SD-OCT could be a very useful screening method for HCQ maculopathy, from its early stages.
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