Evaluation of Changes in the Ganglionic Cell inner Plexiform Layer and Macular Retinal Nerve Fiber Layer in Patients Receiving Hydroxychloroquine
DOI:
https://doi.org/10.35516/jjps.v16i1.1076Keywords:
Hydroxychloroquine, ganglion cell-inner plexiform layer, macular retinal nerve fiber layer, spectral-domain optical coherence tomographyAbstract
Backgrounds: To evaluate changes in the thickness of ganglion cell-inner plexiform layer and macular retinal nerve fiber layer using ocular coherence tomography in patients exposed to hydroxychloroquine .
Methods: This was a retrospective, cross-sectional study of patients on hydroxychloroquine therapy. Ocular coherence tomography images showing ganglion cell-inner plexiform cell layer and macular retinal nerve fiber layer thickness were obtained and compared to controls. The relationship between the thickness of ganglion cell-inner plexiform and macular retinal nerve fiber layer, duration and cumulative dose of hydroxychloroquine were evaluated.
Results: In all, 219 subjects were included. The Thickness of the ganglion cell-inner plexiform thickness was significantly less than controls (p = 0.006). The average macular RNFL thickness was less in the study compared to the control groups, but not statistically significant (p = 0.389). There was no significant correlation between ganglionic cell-inner plexiform and macular retinal nerve fiber layer with duration, daily dose, or cumulative dose of hydroxychloroquine.
Conclusion: Thinning of the ganglionic cell- inner plexiform layer could be an early indicator of retinal toxicity before the appearance of clinical retinopathy.
References
Kellner S, Weinitz S, Kellner U. Spectral domain optical coherence tomography detects early stages of chloroquine retinopathy similar to multifocal electroretinography, fundus autofluorescence and near-infrared autofluorescence. Br J Ophthalmol 2009; 93: 1444-7.
Ouassaf,A.M.,Belaidi,S.,Shtaiwi,A. et al. Quantitative Structure Activity Relationship (QSAR) Investigations and Molecular Docking Analysis of Plasmodium Protein Farnesyltransferase Inhibitors asPotent Antimalarial Jordan j .pharm.sci., 2022; 15(3).
DOI: https://doi.org/10.35516/jjps.v15i3
Levy GD, Munz SJ, Paschal J, et al. Incidence of hydroxychloroquine retinopathy in 1,207 patients in a large multicenter outpatient practice. Arthritis Rheum 1997; 40: 1482-6.
Wolfe F, Marmor MF. Rates and predictors of hydroxychloroquine retinal toxicity in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2010; 62:775-84.
Marmor MF, Kellner U, Lai TY, et al. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology 2011;118:415-22.
Taybeh,E., Al-Alami, Z. Alsous,M.et al. Familiarity and Attitude toward Pharmacovigilance among Pharmacy Academics in Jordanian Universities: A Cross-Sectional Study Jordan j.pharm.sci., 2020; 13(4), 2020- 397.
Costedoat-Chalumeau N, Ingster-Moati I, Leroux G, et al. Critical review of the new recommendations on screening for hydroxychloroquine retinopathy. Rev Med Interne 2012; 33: 265-7.
Yusuf IH, Foot B, Galloway J, et al. The Royal College of Ophthalmologists recommendations on screening for hydroxychloroquine and chloroquine users in the United Kingdom: executive summary. Eye (Lond). 2018 Jul;32(7):1168-1173.
https://doi.org/10.1038/s41433-018-0136-x. Epub 2018 Jun 11. PMID: 29887605; PMCID: PMC6043500.
Nusair M., Alhamad H., Mukattash T., et al. Pharmacy students’ attitudes to provide rational pharmaceutical care: A multi-institutional study in Jordan. Jordan. j. pharm. sci., 2021; 14, (1): 27-36.
Abu Farha R., Saadeh M., Mukattash T.et al. Mohammad Nusair Pharmacy students’ knowledge and perception about the implementation of pharmaceutical care services in Jordan j. pharm. sci., 2021; 14, (1): 103-111.
Lee MG, Kim SJ, Ham DI, et al. Macular retinal ganglion cell-inner plexiform layer thickness in patients on hydroxychloroquine therapy. Invest Ophthalmol Vis Sci 2014; 56: 396-402
De Sisternes L, Hu J, Rubin DL, et al. Localization of damage in progressive hydroxychloroquine retinopathy on and off the drug: inner versus outer retina, parafovea versus peripheral fovea. Invest Ophthalmol Vis Sci 2015; 56: 3415-26.
Stepien KE, Han DP, Schell J, et al. Spectral-domain optical coherence tomography and adaptive optics may detect hydroxychloroquine retinal toxicity before symptomatic vision loss. Trans Am Ophthalmol Soc 2009;107: 28-33.
Chen E, Brown DM, Benz MS, et al. Spectral-domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the "flying saucer" sighn)clin Ophthalmol 2010;4:1151-8.
Bulut M, Erol MK, Toslak D, et al. A New Objective Parameter in Hydroxychloroquine-induced Retinal Toxicity screening Test. Macular Retinal Ganglionic -Inner Plexiform layer Thickness. Arch Rheumatol 2018; 33(1):52-58
https://doi.org/105606/ArchRheumatol.20180.6327
Xiaoyun MA, Dongyi HE, Linping HE. Assessing chloroquine toxicity in RA patients using retinal nerve fiber layer thickness, multifocal electroretinography and visual field test. Br J Ophthalmol 2010;94:1632-6.
Bonanomi MT, Dantas NC, Medeiros FA. Retinal nerve fiber layer thickness measurements in patients using chloroquine. Clin Exp Ophthalmol 2006;34:130-6.
Pasadhika S., Fishman GA. Effects of chronic exposure to hydroxychloroquine or chloroquine on inner retinal structures. Eye (Lond) 2010;24:340-6.
Walia S., Fishman GA. Retinal nerve fiber layer analysis in RP patients using Fourier-domain OCT. Invest Ophthalmol Vis Sci 2008;49:3525-8.
Han J., Lee K., Rhiu S., et al. Linezolid-associated optic neuropathy in a patient with drug-resistant tuberculosis. J Neuroophthalmol 2013;33:316-8
