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Spectral-domain optical coherence tomography in preclinical chloroquine maculopathy in rheumatoid arthritis patients

Session Details

Session Title: Imaging I

Session Date/Time: Friday 18/09/2015 | 08:00-09:30

Paper Time: 09:20

Venue: Athena

First Author: : M.Abd Elmohsen EGYPT

Co Author(s): :    R. Allam   M. Khafagy   K. Raafat   S. Sheta     

Abstract Details

PURPOSE:Is to evaluate the potential role of spectral-domain optical coherence tomography (SD-OCT) in early detection of Chloroquine (CQ) maculopathy in rheumatoid arthritis patients.

Setting:

This cross-sectional observational case-control study was performed on 80 eyes of 80 subjects recruited from the ophthalmology and rheumatology outpatient clinics, Kasr Al-ainy School of Medicine. To avoid a statistical dilemma, only the left eye from each subject was included in the study.

Methods:

40 left eyes of 40 rheumatoid arthritis patients who received treatment chloroquine for more than one year were recruited in the study. All patients had no symptom or sign of CQ retinopathy. After informed consent, all patients underwent full history taking with special attention to disease duration, treatment duration, daily dose and then calculation of the cumulative dose until time of examination. Clinical assessment in the form of complete ophthalmologic examination was done. Color vision was tested using Ishihara Pseudo isochromatic plates. Patients were evaluated using (SD-OCT), where the central foveal thickness (CFT), parafoveal thickness and perifoveal thickness, average Retinal Nerve Fiber Layer (RNFL) thickness, Ganglion Cell Complex (GCC) measurements were measured and the integrity of the IS/OS junction was evaluated. These were compared to same assessments in 40 left eyes of 40 normal individuals.

Results:

the mean CFT was found to be thinner in the Chloroquine group (238.15 µm ± 22.49) than the normal controls (248.2 µm ± 19.04), which was statistically significant (p-value=0.034). The mean parafoveal thickness was lesser in the Chloroquine group than the control group in all quadrants (p-value <0.05). The perifoveal thickness in both groups showed no statistically significant difference (p-value>0.05) in all quadrants. No significant difference was detected between the two groups regarding RNFL, GCC or IS/OS junction. In addition, there was no correlation between neither the treatment duration nor the cumulative dose of Chloroquine and any of the parameters measured by SD-OCT.

Conclusions:

We concluded that preclinical chloroquine toxicity can lead to thinning in the central foveal and parafoveal regions. SD-OCT could be a possible tool for detection of early chloroquine macular toxicity.

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