Optical coherence tomography angiography parameters in patients taking hydroxychloroquine therapy.

Purpose: The aim of this study is to measure retinal vessel density and flow rate area by optical coherence tomography angiography (OCTA) in patients with autoimmune diseases taking hydroxychloroquine (HCQ). Methods: The cross-sectional study included 98 patients divided into three groups. Group I included patients with the diagnosis of an autoimmune disease, for whom the introduction of HCQ was planned. Group II implied low-risk patients for retinal toxicity (≤5 years of HCQ use), whereas Group III implied patients that were at high-risk (>5 years of drug use). All patients underwent a computerized visual field, central macular thickness by optical coherence tomography, and OCTA measurements. Results: The vascular density was found to be statistically significantly decreased in the high-risk group compared to the control group in the superficial parafoveal zone (P = 0.030), whereas it was decreased compared to the low-risk and control groups in the deep layers whole (P = 0.006, P = 0.010, respectively) and perifoveal zones (P = 0.003, P = 0.010, respectively). The foveal avascular zone was significantly enlarged in the high-risk group compared to the control (P < 0.018). Retinal flow rates did not show statistically significant differences between the groups (P > 0.05). Conclusion: Patients treated with HCQ for more than 5 appear have a significant loss of vascular density in the parafoveal and perifoveal regions, and FAZ area is significantly increased compared to low-risk patients and controls. These findings indicate that OCTA may be beneficial for monitoring high-risk patients and may stratify their risk of further retinal damage.

Vision-Related Quality of Life and Treatment Satisfaction Following Panretinal Photocoagulation in Diabetic Retinopathy-A Panel Study.

Background and Objectives: The aim of the study was to evaluate vision-related quality of life (VR-QOL) and treatment satisfaction (TS) in patients with diabetic retinopathy treated with panretinal photocoagulation (PRP). Material and Methods: The panel study included 95 patients who underwent PRP for diabetic retinopathy. Eligible patients with no history of previous PRP were interviewer-administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Retinopathy Treatment Satisfaction Questionnaire (RetTSQ) beforehandand one month after the last session of laser application. The study was conducted between June 2017 and June 2019 at tertiary care center in Serbia, Belgrade. We assessed pre- to post-PRP values of the composite score and subscale scores of VFQ-25 and RetTSQ, using a paired samples t-test. Univariate logistic regression was used to analyze the relationship between binary outcomes and potential predictors. Multivariate regression included predictors from univariate analyses that were statistically significant. Results: The mean VFQ-25 composite score was 65.4 ± 17.4 before and 63.3 ± 19.5 after PRP (p = 0.045). Subscale analysis showed that two of the 11 items achieved a significant decrease after laser application (general vision and dependency). The mean RetTSQ score at baseline was 60.0 ± 11.8 and at the exit visit was 60.3 ± 12.3 (p = 0.858). Sub-scale analysis showed significant deterioration for five of the 13 items. Multivariate logistic regression found that significant predictor of VFQ-25 composite score reduction was fewer laser burns (p = 0.002) while significant predictor of RetTSQ total score reduction was presence of hyperlipidaemia (p = 0.021). Conclusion: The use of vision-related quality of life and treatment satisfaction questionnaires in conjunction with clinical examination, appears to provide a more comprehensive overview of an individual's daily well-being following PRP. Laser treatment for diabetic retinopathy leads to deterioration of some of the patients' perceived VR-QOL and TS. Health-care providers should inform patients about their treatment options and together decide which therapeutic method is best for them.

Ocular pulse amplitude after panretinal photocoagulation in normotensive eyes with proliferative diabetic retinopathy.

PURPOSE: To assess the effect of panretinal laser photocoagulation on ocular pulse amplitude (OPA) in normotensive eyes with proliferative diabetic retinopathy. METHODS: Prospectively, we performed unilateral argon laser panretinal photocoagulation (PRP) in 30 patients with diabetes mellitus type II and previously untreated bilateral proliferative diabetic retinopathy. Before and 7 and 30 days after the treatment, OPA was measured using dynamic contour tonometer. RESULTS: Compared with the untreated contralateral eyes, laser photocoagulation led to a reduction of OPA. Ocular pulse amplitude did not significantly differ in photocoagulated eyes 7 days after the treatment, but there was a significant difference in OPA 30 days after the treatment. The decrease in OPA values was 15% 7 days after PRP and 40% 30 days after PRP. CONCLUSIONS: Ocular pulse amplitude reduction after PRP indirectly informs us about choriocapillary closure, already reported in previous studies.