Evaluation of corneal safety in systemic lupus erythematosus patients undergoing long-term hydroxychloroquine treatment

Cutan Ocul Toxicol. 2021 Mar;40(1):21-25. doi: 10.1080/15569527.2020.1861003. Epub 2020 Dec 23.

Abstract

Purpose: The aim of this study was to examine the effects of long-term use of hydroxychloroquine (HQ) on the pachymetric, aberrometric, and densitometric values of the cornea and corneal endothelium in lupus patients.

Method: Twenty-two eyes (study group) of 22 patients using HQ for treatment of lupus and 25 eyes (control group) of 25 healthy individuals were included in this prospective study. A specular microscopy was used to measure corneal endothelial cell density (ECD), percentage of hexagonal cells (HEX%), coefficient of variation of the cell size (CV). Then, a Pentacam® HR corneal tomography system was used to measure central corneal thickness (CCT), corneal aberrometry values in 6-mm pupil diameters and corneal densitometry values in 6-mm corneal zones (0-2 mm and 2-6 mm).

Results: While ECD was significantly lower in the study group than in the control group (p = 0.034), CCT was significantly higher in the study group (p = 0.032). The higher-order aberrations values and the anterior corneal densitometry values in the 0-2 mm and 2-6 mm corneal zones in the study group were found to be significantly higher than the control group (p = 0.021, p = 0.007 and p = 0.013).

Conclusion: Prolonged use of HQ may cause some changes in the cornea. In the follow-up of these cases, detailed examination of the cornea as well as the macula may be important for the protection of corneal health.

Keywords: Corneal changes; hydroxychloroquine; lupus; pentacam; specular microscopy.

Publication types

  • Observational Study

MeSH terms

  • Aberrometry
  • Adolescent
  • Adult
  • Cornea / diagnostic imaging
  • Cornea / drug effects*
  • Corneal Diseases / chemically induced
  • Corneal Diseases / prevention & control*
  • Corneal Pachymetry
  • Cross-Sectional Studies
  • Densitometry
  • Endothelium, Corneal / diagnostic imaging
  • Endothelium, Corneal / drug effects*
  • Female
  • Healthy Volunteers
  • Humans
  • Hydroxychloroquine / adverse effects*
  • Lupus Erythematosus, Systemic / drug therapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Tomography, Optical Coherence
  • Young Adult

Substances

  • Hydroxychloroquine