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Journal of Ophthalmology
Volume 2016 (2016), Article ID 8643174, 8 pages
Research Article

Effect of Hydroxychloroquine on the Retinal Layers: A Quantitative Evaluation with Spectral-Domain Optical Coherence Tomography

1Department of Ophthalmology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey
2Department of Rheumatology, Fatih University Medical Faculty Hospital, 34844 Istanbul, Turkey

Received 7 March 2016; Revised 13 July 2016; Accepted 19 July 2016

Academic Editor: Suphi Taneri

Copyright © 2016 Hasim Uslu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 (). RPE-Bruch’s membrane complex thicknesses were significantly higher in the hydroxychloroquine subjects than for those of the control subjects (). The minimum and temporal-inferior macular GCIPL thicknesses were significantly different between the patients with hydroxychloroquine use and the control subjects ( and , 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.