Skip to main content

Advertisement

Log in

Analysis of the outer retinal thickness pixel maps for the screening of hydroxychloroquine retinopathy

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe the findings and new interpretation methods of retinal thickness maps in the setting of hydroxychloroquine (HCQ) therapy.

Methods

A case series of 27 patients with a history of HCQ intake of more than 5 years and 21 normal subjects as the control group were studied. Patients were tested using swept-source optical coherence tomography (OCT). Custom-made 10 × 10 retinal thickness pixel maps of the 6 mm⨯6 mm area centered on the fovea were created for the full, inner, and outer retina of each eye and normal values obtained from the control group were used to calculate the statistical significance of each pixel and highlight suspicious pixels. A pixel was shown with light or dark gray color if its p value was ≤ 0.05 or ≤ 0.01, respectively. Cross-sectional OCT images and visual fields were examined as well and used to confirm the diagnosis of HCQ retinopathy.

Results

The pixel outer retinal thickness maps appeared accurate in detecting lesions even in eyes with unremarkable full retina thickness maps. The size and location of atrophic retinal defects were shown on pixel maps. Outer retinal thickness maps were able in differentiating outer retinal thinning from inner retinal thinning as the hallmark of HCQ retinopathy.

Conclusion

Outer retinal thickness pixel maps can be used for the screening of HCQ retinopathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ruiz-Irastorza G, Ramos-Casals M, Brito-Zeron P, Khamashta MA (2010) Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus. Ann Rheum Dis 69:20–28. https://doi.org/10.1136/ard.2008.101766

    Article  CAS  PubMed  Google Scholar 

  2. Rainsford KD, Parke AL, Clifford-Rashotte M, Kean WF (2015) Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases. Inflammopharmacology 23:231–269. https://doi.org/10.1007/s10787-015-0239-y

    Article  CAS  PubMed  Google Scholar 

  3. Kim KE, Ahn SJ, Woo SJ, Park KH, Lee BR, Lee Y, Sung Y (2021) Use of OCT retinal thickness deviation map for hydroxychloroquine retinopathy screening. Ophthalmology 128:110–119. https://doi.org/10.1016/j.ophtha.2020.06.021

    Article  PubMed  Google Scholar 

  4. Palazon-Cabanes A, Palazon-Cabanes B, Rubio-Velazquez E, Lopez-Bernal MD, Garcia-Medina JJ, Villegas-Perez MP (2020) Normative database for all retinal layer thicknesses using SD-OCT posterior pole algorithm and the effects of age, gender and axial length. J Clin Med 9:3317–3332. https://doi.org/10.3390/jcm9103317

    Article  PubMed  PubMed Central  Google Scholar 

  5. Invernizzi A, Pellegrini M, Acquistapace A, Benatti E, Erba S, Cozzi M, Cigada M, Viola F, Gillies M, Staurenghi G (2018) Normative data for retinal-layer thickness maps generated by spectral-domain OCT in a white population. Ophthalmol Retina 2:808–815. https://doi.org/10.1016/j.oret.2017.12.012

    Article  PubMed  Google Scholar 

  6. Scuderi G, Fragiotta S, Scuderi L, Iodice CM, Perdicchi A (2020) Ganglion cell complex analysis in glaucoma patients: what can it tell us? Eye Brain 12:33–44. https://doi.org/10.2147/EB.S226319

    Article  PubMed  PubMed Central  Google Scholar 

  7. Marmor MF, Kellner U, Lai TYY, Melles RB, Mieler WF (2016) Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology 123(6):1386–1394. https://doi.org/10.1016/j.ophtha.2016.01.058

    Article  PubMed  Google Scholar 

  8. De Sisternes L, Hu J, Rubin DL, Marmor MF (2016) Analysis of inner and outer retinal thickness in patients using hydroxychloroquine prior to development of retinopathy. JAMA Ophthalmol 134:511–519. https://doi.org/10.1001/jamaophthalmol.2016.0155

    Article  PubMed  Google Scholar 

  9. Casado A, López-de-Eguileta A, Soraya Fonseca S, Muñoz P, Demetrio R, Gordo-Vega MA, Andrea Cerveró A (2020) Outer nuclear layer damage for detection of early retinal toxicity of hydroxychloroquine. Biomedicines 8(3):54–63. https://doi.org/10.3390/biomedicines8030054

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Garrity ST, Jung JY, Zambrowski O, Pichi F, Su D, Arya M, Waheed NK, Duker JS, Chetrit Y, Miserocchi E, Giuffrè C, Kaden TR, Querques G, Souied EH, Freund KB, Sarraf D (2019) Early hydroxychloroquine retinopathy: optical coherence tomography abnormalities preceding Humphrey visual field defects. Case Rep Br J Ophthalmol 103:1600–1604. https://doi.org/10.1136/bjophthalmol-2018-313350

    Article  Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed equally to the study conception and design, data collection and analysis, and writing of the manuscript.

Corresponding author

Correspondence to Kia Tarassoly.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tarassoly, K., Miraftabi, A., Sedaghat, A. et al. Analysis of the outer retinal thickness pixel maps for the screening of hydroxychloroquine retinopathy. Int Ophthalmol 43, 1737–1743 (2023). https://doi.org/10.1007/s10792-022-02573-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-022-02573-2

Keywords

Navigation