Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study

Stefano Sebastiani, Michela Fresina, Mauro Cellini, Emilio C Campos Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy Purpose: To evaluate early changes in multifocal electroretinogram (mfERG) and subclinical aqueous humor...

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Autores principales:	Sebastiani S, Fresina M, Cellini M, Campos EC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Hydroxychloroquine Multifocal Electroretinography Laser flare-cell photometry Rheumatoid Arthritis Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c6edf1be500944d7b928bb6b237341ff
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spelling	oai:doaj.org-article:c6edf1be500944d7b928bb6b237341ff2021-12-02T02:28:20ZHydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study1177-5483https://doaj.org/article/c6edf1be500944d7b928bb6b237341ff2017-04-01T00:00:00Zhttps://www.dovepress.com/hydroxychloroquine-for-treatment-of-rheumatoid-arthritis-multifocal-el-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Stefano Sebastiani, Michela Fresina, Mauro Cellini, Emilio C Campos Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy Purpose: To evaluate early changes in multifocal electroretinogram (mfERG) and subclinical aqueous humor flare and cellularity in patients receiving hydroxychloroquine (HCQ) as treatment for rheumatoid arthritis.Methods: Ten patients receiving treatment with HCQ and no ophthalmic symptoms were enrolled. After complete ocular examination, mfERG and laser flare-cell photometry were performed. Patients were also divided into two subgroups with HCQ cumulative dose (CD) higher or lower than 500 g. Results obtained were compared with a control group of ten healthy subjects and statistical analysis was performed.Results: In patients receiving HCQ treatment, mfERG P1-wave in ring 2 showed a significant reduction in amplitude and a significant increase in latency compared to healthy control subjects, respectively resulting in 1.143 µV vs 1.316 µV (P=0.040) and 38.611 ms vs 36.334 ms (P=0.024). These changes are highly related to CD. Furthermore, when using the laser flare-cell photometry, a significant increase in aqueous humor flare and cellularity was shown in patients with CD higher than 500 g, resulting in a mean value of 14.4 ph/ms compared to 8.1 ph/ms in patients with CD lower than 500 g (P=0.0029). These reports appear highly related to CD (P=0.001). Receiver operating characteristic curve analysis showed mfERG P1-wave amplitude in ring 2 as the most sensitive value in detecting early HCQ-related retinopathy.Conclusion: MfERG was shown to be a very sensitive test in detecting early retinal toxicity and should be used for the screening of patients receiving HCQ treatment. Although less sensitive, laser flare-cell photometry can provide further information to evaluate early toxic retinal cell damage. Keywords: hydroxychloroquine, multifocal electroretinography, laser flare-cell photometry, rheumatoid arthritisSebastiani SFresina MCellini MCampos ECDove Medical PressarticleHydroxychloroquineMultifocal ElectroretinographyLaser flare-cell photometryRheumatoid ArthritisOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 689-696 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hydroxychloroquine Multifocal Electroretinography Laser flare-cell photometry Rheumatoid Arthritis Ophthalmology RE1-994
spellingShingle	Hydroxychloroquine Multifocal Electroretinography Laser flare-cell photometry Rheumatoid Arthritis Ophthalmology RE1-994 Sebastiani S Fresina M Cellini M Campos EC Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
description	Stefano Sebastiani, Michela Fresina, Mauro Cellini, Emilio C Campos Department of Experimental, Diagnostic, and Specialty Medicine, Ophthalmology Service, University of Bologna, Bologna, Italy Purpose: To evaluate early changes in multifocal electroretinogram (mfERG) and subclinical aqueous humor flare and cellularity in patients receiving hydroxychloroquine (HCQ) as treatment for rheumatoid arthritis.Methods: Ten patients receiving treatment with HCQ and no ophthalmic symptoms were enrolled. After complete ocular examination, mfERG and laser flare-cell photometry were performed. Patients were also divided into two subgroups with HCQ cumulative dose (CD) higher or lower than 500 g. Results obtained were compared with a control group of ten healthy subjects and statistical analysis was performed.Results: In patients receiving HCQ treatment, mfERG P1-wave in ring 2 showed a significant reduction in amplitude and a significant increase in latency compared to healthy control subjects, respectively resulting in 1.143 µV vs 1.316 µV (P=0.040) and 38.611 ms vs 36.334 ms (P=0.024). These changes are highly related to CD. Furthermore, when using the laser flare-cell photometry, a significant increase in aqueous humor flare and cellularity was shown in patients with CD higher than 500 g, resulting in a mean value of 14.4 ph/ms compared to 8.1 ph/ms in patients with CD lower than 500 g (P=0.0029). These reports appear highly related to CD (P=0.001). Receiver operating characteristic curve analysis showed mfERG P1-wave amplitude in ring 2 as the most sensitive value in detecting early HCQ-related retinopathy.Conclusion: MfERG was shown to be a very sensitive test in detecting early retinal toxicity and should be used for the screening of patients receiving HCQ treatment. Although less sensitive, laser flare-cell photometry can provide further information to evaluate early toxic retinal cell damage. Keywords: hydroxychloroquine, multifocal electroretinography, laser flare-cell photometry, rheumatoid arthritis
format	article
author	Sebastiani S Fresina M Cellini M Campos EC
author_facet	Sebastiani S Fresina M Cellini M Campos EC
author_sort	Sebastiani S
title	Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
title_short	Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
title_full	Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
title_fullStr	Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
title_full_unstemmed	Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
title_sort	hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c6edf1be500944d7b928bb6b237341ff
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_version_	1718402493523689472

Hydroxychloroquine for treatment of rheumatoid arthritis: multifocal electroretinogram and laser flare-cell photometry study

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