Background: The patients with early retinopathy can be asymptomatic with normal fundus before any signs of maculopathy appear; hence, screening for early detection in the premaculopathy stage is recommended. Spectral domain optical coherence tomography (SD-OCT) detects early structural damage to macula in patients on hydroxychloroquine (HCQ) therapy.
Aim of the work: To evaluate the role of spectral-domain optical coherence tomography (SD-OCT) in early detection of hydroxyl-chloroquine (HCQ) maculopathy.
Patients and methods: This cross-sectional observational study was conducted between November 2017 and November 2019 on 100 adult female patients taking HCQ referred from the ophthalmology and rheumatology outpatient clinics of Ain Shams University Hospital. The age of the participants ranged between 25 and 60 years. Fifty age and sex matched healthy subjects were assessed as a control group. The study was conducted in accordance with the ethical standards stated in the Faculty of Medicine - Ain Shams University, with informed consent obtained.
Results: The mean central foveal thickness was found to be thinner in the hydroxychloroquine group than the normal controls, which was statistically significant (p value = 0.042). The upper, lower, nasal and temporal parafoveal thickness were thinner in the hydroxychloroquine group in comparison to that of the control group (p value = 0.001, 0.020, 0.001 & 0.001 respectively). The upper, temporal and lower perifoveal thickness showed statistically significant thinning in the hydroxychloroquine group (p value = 0.002, < 0.001 & 0.041 respectively) in all quadrants except the nasal quadrant which was not statistically significant (p = 0.169). No significant difference was detected between the two groups regarding ganglion cell complex thickness.
Conclusion: Preclinical hydroxychloroquine toxicity can lead to early thinning in the central fovea as well as the parafoveal and perifoveal regions that is detected by SD-OCT.