Spectral-Domain Optical Coherence Tomography of Preclinical Chloroquine Maculopathy in Egyptian Rheumatoid Arthritis Patients

Purpose. To evaluate the role of spectral-domain optical coherence tomography (SD-OCT) in early detection of Chloroquine maculopathy in rheumatoid arthritis (RA) patients. Methods. 40 left eyes of 40 female rheumatoid arthritis patients who received treatment chloroquine for more than one year were recruited in the study. All patients had no symptoms or signs of Chloroquine retinopathy. They were evaluated using SD-OCT, where the Central Foveal Thickness (CFT), parafoveal thickness and perifoveal thickness, average Retinal Nerve Fiber Layer (RNFL) thickness, and Ganglion Cell Complex (GCC) measurements were measured and compared to 40 left eyes of 40 normal females. Results. The mean CFT was found to be thinner in the Chloroquine group (238.15 µm ± 22.49) than the normal controls (248.2 µm ± 19.04), which was statistically significant (p value = 0.034). The mean parafoveal thickness was lesser in the Chloroquine group than the control group in all quadrants (p value 0.05) in all quadrants. No significant difference was detected between the two groups regarding RNFL, GCC, or IS/OS junction. Conclusions. Preclinical Chloroquine toxicity can lead to early thinning in the central fovea as well as the parafoveal regions that is detected by SD-OCT

Optical coherence tomography angiography (OCTA) findings in juvenile idiopathic arthritis

Aim of the work: To report optical coherence tomography angiography (OCTA) findings in juvenile idiopathic arthritis (JIA) patients and to study the relation to disease activity. Patients and methods: The study included 20 JIA patients (38 eyes) who underwent ophthalmologic and rheumatologic examination plus OCT/OCTA. Juvenile arthritis disease activity score (JADAS27) was assessed, and patients were divided into those with no/low activity (group 1; n = 13) and moderate/severe activity (group 2; n = 7). OCTA findings were compared with 11 control (11 eyes). Results: The study included 20 JIA-U patients (38 eyes) with a mean age of 10.7 ± 2.6 years and disease duration of 72.5 ± 34.7 months and they were 9/20 (45 %) females. 13(65 %) patients had no/mild activity (group 1, 25 eyes) while 7(35 %) had moderate to severe activity (group 2, 13 eyes). The mean foveal superficial and deep capillary plexuses (SCP/DCP) vascular density (VD) were significantly lower in patients with moderate/severe activity (3x3 scan: p = 0.001 and p < 0.001; 6x6 scan p = 0.008 and p = 0.001 respectively). The foveal avascular zone (FAZ) 3x3 and 6x6 scans were significantly increased and the central macular thickness (CMT) decreased in patients with moderate/severe disease activity (p < 0.001, p = 0.001, and p = 0.001). Fovea SCP VD in 6x6 and 3x3 scans were significantly different between JIA subtypes (p = 0.01 and p = 0.03, respectively), with less VD in oligoarticular type. FAZ, CMT and DCP-VD significantly correlated with visual analogue scale (r = 0.58, p < 0.001; r = −0.5, p = 0.01; r = −0.58, p < 0.001, respectively). Conclusions: Non-invasive OCTA-derived vascular parameters of the macula could be potential biomarkers for evaluating the severity of the systemic disease activity in JIA patients