Effect of hydroxychloroquine on the retinal layers: A quantitative evaluation with spectral-domain optical coherence tomography

Purpose. to evaluate the effect of hydroxychloroquine on retinal pigment epithelium- (rpe-) bruch's membrane complex,photoreceptor outer segment,and macular ganglion cell-inner plexiform layer (gcipl) thicknesses using spectral-domain optical coherence tomography (sd-oct). methods. in this prospective case-control study,51 eyes of 51 hydroxychloroquine patients and 30 eyes of 30 healthy subjects were included. high-quality images were obtained using a cirrus hd-oct with 5-line raster mode; the photoreceptor inner segment (is) and outer segment (os),sum of the segments (is + os),and rpe-bruch's membrane complex were analyzed. results. the thicknesses of the is + os and os layers were significantly lower in the hydroxychloroquine subjects compared to the control subjects (p < 0.05). rpe-bruch's membrane complex thicknesses were significantly higher in the hydroxychloroquine subjects than for those of the control subjects (p < 0.05). the minimum and temporal-inferior macular gcipl thicknesses were significantly different between the patients with hydroxychloroquine use and the control subjects (p = 0.04 and p = 0.03,resp.). conclusions. the foveal photoreceptor os thinning,loss of gcipl,and rpe-bruch's membrane thickening were detected in patients with hydroxychloroquine therapy. this quantitative approach using sd-oct images may have important implications to use as an early indicator of retinal toxicity without any visible signs of hydroxychloroquine retinopathy. © 2016 hasim uslu et al.