Follow‐up of patients under therapy with hydroxichloroquine via merg, sd‐oct, af and automated perimetry

Abstract

AbstractPurpose To analyze alterations in patients in therapy with hydroxychloroquine via multiple functional tests.Methods We examined 55 patients (mean age 56.1±1.9) in long term therapy (93.8±95.6 months) with hydroxichloroquine. The patients were divided into 4 patological groups (RA,LES,connectivitis and others) and assuming therapy from less than 5 years (47 eyes), 5 to 10 (28 eyes) and more than 10 (36 eyes). They had a complete ophthalmologic visit, including logMAR visual acuity, multifocal ERG(61 hexagons program), frequency doubling technology, automated perimetry program 10‐2, spectral domain optical coherence tomography and autofluorescence at time 0 and at after 1 year. For the statistical analysis we considered the latencies and amplitudes of the 5 mfERG rings, the mean and pattern deviation (MD, PSD) results of the FDT and SD‐OCT.Results The patients were treated for 78 months in median and the median total dose was 115 gr. We found a reduction of the mfERG rings statistically significant (N1nV1, P1nV1, P1nVdeg1, N1nV2, P1nV2, P1nVdeg2, P1nV3, P1nVdeg3, P1nV4, P1nVdeg4, P1nV5, P1nVdeg5) while PSD and the MD did't show a loss of sensitivity in the follow up. We found a statistically significant thicker in 4 sector of retina(foveal, superior, nasal and periferical inferior)with SD‐OCT. The AF was positive in 9 eyes and negative in 58 eyes and did not change at the follow up.Conclusion In our study mfERG has been the first exam to show early damage in absence of manifest retinal changes. The meaning of thickening at SD‐OCT remains uncertain. Our aim now is to estabilish the eventual relationship between the thickened areas in SD‐OCT and the mfERG reduction lasting the follow up.