Choroidal Thinning Associated With Hydroxychloroq.uine Retinopathy

Abstract

PURPOSE: To investigate choroidal thickness in patients using hydroxychloroquine (HCQ) and compare choroidal thickness between eyes with and without HCQ retinopathy.DESIGN: Retrospective case series.METHODS: SETTING: Institutional. PATIENTS: We included 124 patients with systemic lupus erythematosus or rheumatoid arthritis who were treated with HCQ. The patients were divided into an HCQ retinopathy group and a control group, according to the presence or absence of HCQ retinopathy. OBSERVATION: Total choroidal thickness and choriocapillaris-equivalent thickness were measured manually by 2 independent investigators using swept-source optical coherence tomography (SS-OCT; DRI-OCT, Topcon Inc, Tokyo, Japan). These measurements were made at the fovea and at nasal and temporal locations 0.5, 1.5, and 3 mm from the fovea. Medium to -large vessel layer thickness was calculated accordingly. The thicknesses were compared between: the HCQ retinopathy and control groups. We performed correlation analyses between choroidal thicknesses and details regarding HCQ use. MAIN OUTCOME MEASURES: Total choroidal thickness and choriocapillaris-equivalent thickness.RESULTS: Choroidal thicknesses were significantly decreased (P < .05) in the HCQ retinopathy group compared to the control group, except at the temporal choroid 1.5 mm from the fovea. Choriocapillaris-equivalent thicknesses were significantly different in all choroidal locations between the groups. In contrast, the medium-to-large vessel layer thickness was only significantly different at a few locations. The cumulative dose/body weight was significantly correlated with subfoveal choroidal and choriocapillaris-equivalent thicknesses (both P = .001). The association between presence of HCQ retinopathy and choroidal thicknesses was also statistically significant after adjusting for age, diagnosis for HCQ use, refractive errors, and duration of HCQ use (P = .001 and P = .003 for subfoveal choroidal and choriocapillaris-equivalent thickness, respectively).CONCLUSIONS: These results all suggest that HCQ retinopathy is associated with choroidal thinning, especially in the choriocapillaris. Our results may suggest choroidal involvement of HCQ-toxicity. (C) 2017 Elsevier Inc. All rights reserved.