Perifoveal cupping detected by optical coherence tomography may represent an early sign of antimalarial-associated maculopathy

Amaç: Antimalaryal ilaç kullanan hastalarda spectral domain optik koherens tomografi kullanılarak foveal yapısal değişiklikleri değerlendirmek. Gereç ve Yöntem: Çalışma bir gözlemsel vaka-kontrol çalışması olarak kurgulandı. Klorakin veya hidroksiklorakin alan 28 hasta ile benzer demografik özelliklere sahip 20 kontrol olgusu spektral domain optik koherens tomografi ve otomatize görme alanı ile klinik olarak değerlendirilerek bulgular karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 34.2 yaş (22 to 40 yaş) idi. Tüm hastalar kadındı. Kontrol olgularının tümü kadın olup yaş ortalaması 31.4 yaş (19-42) idi. Antimalaryal ilaç alan hastaların onsekizinde görme alanı defekti bulunmadan hafif retina pigment epitel değişikliği ve optik koherens tomografi ile saptanan perifoveal çanaklaşma mevcuttu. Geri kalan hastalarda ve de kontrol grubundaki bireylerde santral foveal kalınlıklar gibi perifoveal retinal kalınlıklar da herhangi bir anlamlı fark göstermedi. Bu olgularda perifoveal çanaklaşma ve görme alanı defekti saptanmadı. Perifoveal çanaklaşma olan ve çanaklaşma olmayan hastalardaki santral foveal kalınlıklar sırasıyla 219.57±20.12 μm ve 222.42±24.02 μm idi. Optik koherens tomografi ile saptanan ortalama santral foveal kalınlık hasta grubunda 221.13±25.44 μm (201248 μm aralığında) ve kontrol grubunda 218.96±22.02 μm (189239 μm aralığında) idi. Gruplar arasındaki farklılık istatistiksel olarak anlamlı değildi (p=0.740). Sonuç: Perifoveal çanaklaşma,diğer değişle perifoveal retinal incelme antimalaryal ile ilişkili makulopatinin gelişiyor olduğunu gösteren bir prediktor olabilir.

Optik koherens tomografi ile saptanan perifoveal çanaklaşma antimalaryal ilişkili makulopatinin erken bulgusu olabilir

Objective: To evaluate foveal structural changes by spectral domain optical coherence tomography (Sd-OCT) in patients receiving antimalarials. Materials and Methods: The study was designed as an observational case-control study. Twenty eight patients receiving chloroquine (CQ) or hydroxychloroquine (HCQ) were evaluated clinically using Sd-OCT and automated visual fields. Twenty age-matched subjects serving as controls were imaged with Sd-OCT. Results: The mean age of the patients was 34.2 years (ranged from 22 to 40 years). All patients were female. The control subjects were included twenty females (mean age: 31.4; ranged from 19 to 42 years). Eighteen patients receiving anti-malarial drugs had mild retina pigment epithelium (RPE) changes and perifoveal cupping detected by Sd-OCT without visual field defect. In the rest of patients in and the controls, perifoveal retinal thicknesses as well as central foveal thicknesses did not show any significant difference. These cases had not perifoveal cupping and visual field defect. The mean central foveal thicknesses in the patients with perifoveal cupping and without perifoveal cupping were 219.57±20.12 μm and 222.42±24.02 μm, respectively. The mean central foveal thickness, as determined by OCT, was 221.13±25.44 (range 201248 μm) in the patients and 218.96±22.02 μm (range 189239 μm) in controls. The difference between the groups was not statistically significant (p=0.7). Conclusion: Perifoveal cupping, in the other words, perifoveal retinal thinning may be a predictor for impending antimalarial related maculopathy.

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