Título / Title

ADAPTIVE OPTICS CONE ARRANGEMENT IN HYDROXYCHLOROQUINE USERS WITHOUT SIGNS OF RETINAL TOXICITY: A CASE-CONTROL STUDY

Introdução / Purpose

To determine whether adaptive optics can detect early photoreceptor changes in patients undergoing chronic treatment with hydroxychloroquine (cumulative dosage exceeding 1600 grams) who show no detectable alterations in traditional evaluations, primarily visual field and OCT.

Material e Método / Methods

Case-control study was conducted involving 36 eyes of 36 female patients. These participants were divided into two groups: a control group comprising 18 eyes – in which the participants are healthy and without ocular pathologies – and a group of participants with autoimmune diseases who were using hydroxychloroquine whose cumulative dose exceeded 1600g. Despite the high cumulative dosage, this group did not exhibit signs of maculopathy according to gold-standard evaluation methods, including visual fields, SD-OCT, and Multifocal ERG.

Resultados / Results

The control group exhibited mean nasal and temporal photoreceptor densities of 28967 ± 1759.85 and 29446 ± 1934.27 cells/mm², respectively, along with mean nasal and temporal spacing of 6.47 ± 0.193 and 6.43 ± 0.205 µm. Conversely, the case group showed mean nasal and temporal photoreceptor densities of 26967 ± 1667.97 and 26099 ± 2052.49 cells/mm², respectively, accompanied by mean nasal and temporal spacing of 6.72 ± 0.199 and 6.84 ± 0.283 µm. A higher density and smaller spacing of photoreceptors were observed in the control group. This observation is supported by the independent t-test results, indicating a statistically significant difference between the two groups.

Discussão e Conclusões / Conclusion

Chronic users of hydroxychloroquine, particularly those with over 10 years of usage, require meticulous and thorough monitoring. They may manifest early stages of toxicity that could elude detection through conventional testing methods.

Palavras Chave

Adaptive Optics, Hydroxychloroquine, Retinopathy, Toxicity

Area

CLINICAL RETINA

Institutions

Hospital das Clínicas de Ribeirão Preto - USP - Ribeirão Preto - São Paulo - Brasil

Authors

JOÃO PEDRO ROMERO BRAGA, MOISÉS MOURA DE LUCENA, MURILO WENDEBORN RODRIGUES, ARTHUR ZUPELLI, INGRID U SCOTT, ANDRÉ MÁRCIO VIEIRA MESSIAS, RODRIGO JORGE