Macula pigment optical densitometry changes in hydroxychloroquine use.

PURPOSE: To investigate the association between hydroxychloroquine (HCQ) use and macular pigment optic densitometry (MPOD) abnormalities. MATERIALS AND METHODS: Fifty patients that have been receiving HCQ treatment and forty-eight control subjects were randomly selected from patients with no visual impairment with similar age and gender. All participants underwent detailed ophthalmologic examination including fundus photography, fundus autofluorescence, optic coherence tomography, and visual field analysis. Macular pigment optical density (MPOD) was measured by fundus reflectometry using one-wavelength reflection method. Patients with ongoing HCQ treatment formed the HCQ group and healthy subjects formed the control group. RESULTS: Mean age was 50.9 ± 7.9 and 47.9 ± 9.4 years in the HCQ and controls groups respectively (p = 0.098) Between the groups, there is no significant difference in central foveal thickness and mean deviation and pattern standard deviation in the visual field analysis. Parafoveal hyper fluorescence lesions were detected in 5 (%10) patients. Choroidal thickness was significantly decreased in the HCQ group (p = 0.001). Maximum and mean MPOD outcomes were significantly lower in the HCQ group (p = 0.005, p = 0.003, respectively). Between the groups, there was no difference in mean MPOD volume and MPOD area. CONCLUSIONS: Patients with HCQ use have reduced MPOD. Further studies are required investigating the sensitivity and specificity of MPOD in detecting initial retinal changes in patients with HCQ use.

The effects of adjuvant hormonotherapy on tear functions in patients with breast cancer.

PURPOSE: Aromatase inhibitors (anastrozole, letrozole) and selective estrogen receptor modulators (tamoxifen) are widely used as adjuvant hormonal therapy in women with hormone receptor-positive breast cancer. We aimed to evaluate the effects of oral adjuvant hormonotherapy on tear functions in patients with breast cancer. METHODS: In this case-control study, we enrolled eligible patients with breast cancer who were receiving regular medical selective estrogen receptor modulator (tamoxifen, n:50), aromatase inhibitors (anastrozole, letrozole, n:50) and gender-matched healthy controls (n:50). Tear functions were measured and compared by the Schirmer test, fluorescein breakup time, corneal staining evaluated by Oxford grading scale and Ocular Surface Disease Index scores. RESULTS: Mean age was 49.95 (± 9.2), 51.52 (± 7.2) and 51.91 (± 10.3) in tamoxifen, aromatase inhibitors groups and controls (p = 0.426). Mean duration of BC diagnosis (p = 0.536) and drug use (p = 0.417) was not significant between two groups. Ocular Surface Disease Index scores were lower (p < 0.001), and fluorescein breakup time measurements were higher (p < 0.001) in controls. Schirmer test scores were higher in controls than aromatase inhibitors group (p < 0.001). According to the scores of all measurements, the differences between aromatase inhibitors and tamoxifen groups were statistically significant (p < 0.001). CONCLUSIONS: Our results demonstrated a high difference in all parameters in patients receiving aromatase inhibitors compared to tamoxifen group and controls. Aromatase inhibitors, which reduce estrogen levels in the blood, might affect the tear functions more than tamoxifen, which affects as antiestrogenic on estrogen receptors.