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Long-Term Progression of Pericentral Hydroxychloroquine Retinopathy

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Abstract
Purpose: To investigate the long-term progression of pericentral hydroxychloroquine retinopathy.

Design: Multicenter, retrospective cohort study.

Participants: Eighty eyes (60 with pericentral pattern) of 41 Korean patients with hydroxychloroquine retinopathy followed up for 2 years or more after drug cessation.

Methods: Patients were screened for hydroxychloroquine retinopathy using spectral-domain or sweptsource OCT, fundus autofluorescence (FAF), and Humphrey visual field (VF) tests. Follow-up was divided into short-term (<= 2 years) and subsequent periods, and progression was evaluated in each period and severity group. Retinopathy progression on OCT was defined as increased length of the ellipsoid zone defect, decreased distance from the fovea to the photoreceptor defects, or newly developed or enlarged retinal pigment epithelium defects. On FAF, progression was defined as an increase in the area of hyperautofluorescence or hypoautofluorescence. Functional progression was defined as a regression coefficient of less than 0 dB/year for mean deviation and more than 0 dB/year for pattern standard deviation, based on linear regression analysis of 3 or more VF tests. Structural and functional progression rates were calculated using the slopes of retinal thicknesses on the Early Treatment Diabetic Retinopathy Study grid and perimetric parameters over time, respectively.

Main Outcome Measures: Structural and functional progression of retinopathy.

Results: Approximately one third of eyes with early pericentral retinopathy showed limited progression during the short-term period after drug cessation, but they subsequently showed stable or improved photoreceptors. Most eyes with moderate pericentral retinopathy showed continuous progression, particularly when converted to the severe stage. Severe eyes showed progressive damage throughout the follow-up period. In all severity groups, the rates of retinal thinning decreased over time. In eyes with pericentral retinopathy showing progression, circumferential enlargement of retinal damage was prominent in earlier stages, whereas centripetal enlargement of the ring-shaped lesion was noted in advanced stages. Functional progression, noted in 58.7% of the pericentral eyes, corresponded with structural progression.

Conclusions: Pericentral hydroxychloroquine retinopathy showed severity-dependent progression. Moderate pericentral retinopathy usually progressed, but centripetal progression threatening the fovea was remarkable mostly in severe retinopathy. Our results suggest that early detection of retinopathy may minimize the risk of progression to foveal involvement in pericentral retinopathy. (C) 2020 by the American Academy of Ophthalmology
Author(s)
김고은김유정김중곤서의종안성준윤영희이병로이주용
Issued Date
2021
Type
Article
Keyword
automated perimetryfundus autofluorescenceHydroxychloroquine retinopathyOCTPericentral retinopathyProgression
DOI
10.1016/j.ophtha.2020.10.029
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7663
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2456861453&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Long-Term%20Progression%20of%20Pericentral%20Hydroxychloroquine%20Retinopathy&amp;offset=0&amp;pcAvailability=true
Publisher
OPHTHALMOLOGY
Location
미국
Language
한국어
ISSN
0161-6420
Citation Volume
128
Citation Number
6
Citation Start Page
889
Citation End Page
898
Appears in Collections:
Medicine > Medicine
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