The assessment of structural and functional test results for early detection of hydroxychloroquine macular toxicity.

PURPOSE: To assess structural (optical coherence tomography, fundus autofluorescence) and functional (contrast sensitivity and visual field) test results which were used for detecting early retinal changes in patients using oral hydroxychloroquine. METHODS: Patients using oral hydroxychloroquine for at least one year were divided into two groups according to the duration of drug use. Groups 1 and 2 consisted of patients with drug use for more than 5 years and 1-5 years, respectively. The drug-using groups were compared with the control group. The mean retinal nerve fiber layer (RNFL), central macular thickness (CMT), ganglion cell-inner plexiform layer (GC-IPL), static 10-2 visual field, fundus autofluorescence (FAF) imaging, and contrast sensitivity tests were performed and statistically compared between groups. RESULTS: Median and temporal quadrant RNFL thicknesses were found to be statistically significantly lower in the drug groups. In the drug groups, the GC-IPL sectoral and mean thicknesses were found to be statistically lower in all quadrants. Central macular thickness was also found to be similar in all three groups. There was no significant difference between the groups in visual field parameters. Macular FAF images were significantly higher in the drug users, but there was no significant difference between the three groups in foveal FAF images. Contrast sensitivity measurements were significantly lower in the drug groups than in the control group at all spatial frequencies except 6 and 18 cycles/degree. CONCLUSIONS: The combined use of structural and functional tests in patients using hydroxychloroquine provides useful information in detecting early retinal changes.

Evaluation of fundus autofluorescence maging of diabetic patients without retinopathy / Avaliação do exame de imagem de autofluorescência do fundo do olho em pacientes diabéticos sem retinopatia

ABSTRACT Purpose: To evaluate the usefulness of fundus autofluorescence imaging of diabetic patients without retinopathy to investigate early retinal damage. Methods: Fundus autofluorescence images of patients with type 2 diabetes mellitus without retinopathy (diabetic group) and age-sex matched healthy patients (control group) were recorded with a CX-1 digital mydriatic retinal camera after detailed ophthalmologic examinations. MATLAB 2013a software was used to measure the average pixel intensity and average curve width of the macula and fovea. Results: Fifty-six eyes of 28 patients, as the diabetic group, and 54 eyes of 27 healthy patients, as the control group, were included in this study. The mean aggregation index was 168.32 ± 37.18 grayscale units (gsu) in the diabetic group and 152.27 ± 30.39 gsu in the control group (p=0.014). The mean average pixel intensity value of the fovea was 150.87 ± 35.83 gsu the in diabetic group and as 141.51 ± 31.10 gsu in the control group (p=0.060). The average curve width value was statistically higher in the diabetic group than in the control group (71.7 ± 9.2 vs. 59.4 ± 8.6 gsu, respectively, p=0.03). Conclusion: Fundus autofluorescence imaging analysis revealed that diabetic patients without retinopathy have significant fluorescence alterations. Therefore, a noninvasive imaging technique, such as fundus autofluorescence, may be valuable for evaluation of the retina of diabetic patients without retinopathy.

RESUMO Objetivo: Avaliar a utilidade da autofluorescência do fundo de olho de pacientes diabéticos sem retinopatia para investigar lesões precoces na retina. Métodos: Imagens de autofluorescência do fundo de olho de pacientes com diabetes mellitus do tipo 2 sem retinopatia (grupo diabético) e indivíduos saudáveis pareados por idade e sexo (grupo controle) foram registrados com uma câmera retiniana digital midriática CX-1 após exames oftalmológicos detalhados. O software MATLAB 2013a foi usado para medir a intensidade média do pixel e a largura média da curva da mácula e fóvea. Resultados: Cinquenta e seis olhos de 28 pacientes, como o grupo diabético, e 54 olhos de 27 indivíduos saudáveis, como grupo controle, foram incluídos neste estudo. O índice médio de agregação foi de 168,32 ± 37,18 unidades de escala de cinza (gsu) no grupo diabético e em 152,27 ± 30,39 gsu no grupo controle (p = 0,014). O valor médio da intensidade de pixel na fóvea foi de 150,87 ± 35,83 gsu no grupo diabético e de 141,51 ± 31,10 gsu no grupo controle (p=0,060). O valor médio da largura da curva foi estatisticamente maior no grupo diabético do que no grupo controle (71,7 ± 9,2 vs. 59,4 ± 8,6 gsu, respectivamente; p = 0,03). Conclusão: A análise por imagens de autofluorescência de fundo de olho revelou que pacientes diabéticos sem retinopatia apresentam alterações significativas de fluorescência. Portanto, uma técnica de imagem não invasiva, como a autofluorescência de fundo de olho, pode ser valiosa para a avaliação da retina de pacientes diabéticos sem retinopatia.

Evaluation of fundus autofluorescence imaging of diabetic patients without retinopathy.

PURPOSE: To evaluate the usefulness of fundus autofluorescence imaging of diabetic patients without retinopathy to investigate early retinal damage. METHODS: Fundus autofluorescence images of patients with type 2 diabetes mellitus without retinopathy (diabetic group) and age-sex matched healthy patients (control group) were recorded with a CX-1 digital mydriatic retinal camera after detailed ophthalmologic examinations. MATLAB 2013a software was used to measure the average pixel intensity and average curve width of the macula and fovea. RESULTS: Fifty-six eyes of 28 patients, as the diabetic group, and 54 eyes of 27 healthy patients, as the control group, were included in this study. The mean aggregation index was 168.32 ± 37.18 grayscale units (gsu) in the diabetic group and 152.27 ± 30.39 gsu in the control group (p=0.014). The mean average pixel intensity value of the fovea was 150.87 ± 35.83 gsu the in diabetic group and as 141.51 ± 31.10 gsu in the control group (p=0.060). The average curve width value was statistically higher in the diabetic group than in the control group (71.7 ± 9.2 vs. 59.4 ± 8.6 gsu, respectively, p=0.03). CONCLUSION: Fundus autofluorescence imaging analysis revealed that diabetic patients without retinopathy have significant fluorescence alterations. Therefore, a noninvasive imaging technique, such as fundus autofluorescence, may be valuable for evaluation of the retina of diabetic patients without retinopathy.