60 eyes of 31 patients who had been using HCQ for more than five years were formed group 1; 62 eyes of 32 patients using drugs for less than 5 years (at least 1 year) were formed group 2. Control group was composed of 56 eyes of 28 patients with the same diagnoses without using medication.
In the first group, 27 (%87,1) were women, 4 (%12,9) were men; in the second group, 31 (%96,8) were women, 1 (%3,1) were men, and in the control group 26 (%92,8) were women and 2 (%7,2) were men. The mean age of the first group was 49.67 ± 8.25, the mean age of the second group was 49.92 ± 8.22, the average age of the control group was 46.93 ± 6.17 years, and no statistically significant difference was found between the average ages of the three groups. (p:0.066)
The diagnoses of the patients included in the study were SLE (%60,7), RA (%22,5), Sjogren (%12,4), Ankylosing Spondylitis (%1,1), Discoid Lupus (%1,1), Mixed Connective Tissue Disease (%1,1) and Antiphospholipid Syndrome (%1,1).
The HCQ usage period of the patients in group 1 was 8.77 ± 3.01 years; group 2 was 2.67 ± 1.09 years. The cumulative dose amounts they received were calculated as 639.97 ± 217.52 gr and 194.98 ± 79.57 gr. All patients have been taking 200 mg of HCQ daily in our study.
When the thickness analyzes of the patient and control groups were examined, it was found that the sectoral and mean GC-IPL thicknesses were statistically significant in the patient groups compared to the control group (p < 0.05). The ganglion layer thickness was thinner in all quadrants in patient groups (Table 1). When the groups were compared in pairs, a significant difference was found between group 2 and the control group in terms of superior and superior nasal quadrants of the GC-IPL (p < 0.05).
Table 1
GC-IPL thickness measurements of patient and control groups
GC-IPL thickness (µ)
|
Group 1
|
Group 2
|
Control
|
p value
|
Superior
|
84.03 ± 6.61
|
81.42 ± 9.84
|
85.79 ± 6.46
|
0.034*
|
Superior nasal
|
83.35 ± 7.20
|
80.89 ± 11.17
|
86.09 ± 7.06
|
0.011*
|
Superior temporal
|
79.72 ± 6.54
|
77.60 ± 10.78
|
82.82 ± 5.76
|
0.004*
|
Inferior
|
80.40 ± 6.63
|
80.65 ± 10.05
|
84.84 ± 5.60
|
0.003*
|
Inferior nazal
|
81.28 ± 7.70
|
80.98 ± 10.00
|
85.11 ± 7.25
|
0.010*
|
Inferior temporal
|
80.55 ± 7.01
|
80.50 ± 8.99
|
82.68 ± 12.20
|
0.038*
|
Mean
|
81.63 ± 5.41
|
80.35 ± 9.32
|
84.86 ± 5.64
|
0.006*
|
p*<0.05, Kruskal Wallis test |
When the central macular thickness measurements of the patient and control groups were examined, it was observed that there was no statistically significant difference (p > 0.673). When the groups were compared in pairs, no significant difference was found (p > 0.05).
When the RNFL measurements of the groups were examined, temporal quadrant and mean RNFL thicknesses were statistically thinner in the patient groups than in the control group (p < 0.05).
When the RNFL measurements of the groups were examined, temporal quadrant and mean RNFL thicknesses were statistically thinner in the patient groups than in the control groups (p < 0.05, Table 2).
Table 2
RNFL measurements of patient and control groups
RNFL thickness (µ)
|
Group 1
|
Group 2
|
Control
|
p value
|
Superior
|
114.23 ± 14.95
|
113.52 ± 16.42
|
118.89 ± 15.45
|
0.163
|
Inferior
|
119.38 ± 14.94
|
118.48 ± 17.05
|
123.02 ± 14.78
|
0.229
|
Nasal
|
68.73 ± 9.45
|
69.16 ± 10.56
|
73.00 ± 3.43
|
0.241
|
Temporal
|
62.37 ± 9.62
|
60.76 ± 9.15
|
64.70 ± 7.25
|
0.031
|
Mean
|
91.07 ± 8.34
|
90.50 ± 10.65
|
94.98 ± 8.44
|
0.026*
|
*p < 0.05, Kruskal Wallis test |
When the groups were compared in pairs, temporal and mean RNFL thicknesses were significantly thinner in Group 2 than in the control group (p < 0.05).
There was no statistically significant difference in MD and PSD between the three groups (p = 0.150, p = 0.105, Table 3). When MD and PSD measurements were compared between the groups in pairs, no significant difference was found (p > 0.05). When the visual field sensitivity was examined, a significant difference was found between the groups (p:0.028, Table 3).
Table 3
Visual field measurements of patient and control groups
Visual field measurements
|
MD
|
PSD
|
Normal
|
Mild low sensitivity
|
Paracentral scotoma with moderate low sensitivity
|
Paracentral scotoma with complete loss of sensitivity
|
Group 1
|
-3.78 ± 2.13
|
1.50 ± 0.66
|
23 (%38)
|
19 (%31)
|
10 (%16)
|
8 (%13)
|
Group 2
|
-3.07 ± 1.80
|
1.27 ± 0.36
|
36 (%58)
|
18 (%29)
|
8 (%12)
|
0 (%0)
|
Control
|
-3.02 ± 1.4
|
1.37 ± 0.50
|
37(%65c)
|
12 (%21)
|
7 (%12)
|
0 (%0)
|
p value
|
0.150
|
0.105
|
0.028*
|
*p < 0.05, Kruskal Wallis test, Chi-square test (Moderate low sensitivity and complete loss of sensitivity were combined) |
There was a statistically significant difference between groups in terms of the mean macular pixel density (p = 0.013, Table 4). When the groups were compared in pairs, a significant difference was found between Group 1 and the control group (p < 0.05). When the mean fovea pixel densities were evaluated, no significant difference was found between the three groups (p = 0.069, Table 4). When we compared the groups in pairs, no significant difference was seen (p > 0.05).
Table 4
Mean macular and fovea pixel density of patient and control groups
Pixel density
|
Group 1
|
Group 2
|
Control
|
p value
|
Mean macular
|
160.18 ± 26.81
|
156.80 ± 24.99
|
145.67 ± 27.50
|
0.013*
|
Mean fovea
|
155.99 ± 27.77
|
152.96 ± 25.00
|
145.83 ± 25.17
|
0.069
|
*p < 0.05, Kruskal Wallis test |
When the contrast sensitivity measurements were compared, a statistically significant difference was found in all spatial frequencies except 6 and 18 cycles/degree (cpd) (p < 0.05, Table 5). When the groups were compared in pairs, there was a significant difference between Group 1 and the control group at 3 and 12 cpd (p < 0.05). There was a significant difference between Group 2 and the control group at 1, 5 and 6 cpd (p < 0.05).
Table 5
Contrast sensitivity measurements of patient and control groups
Contrast sensitivity measurements (cpd)
|
Group 1
|
Group 2
|
Control
|
p value
|
1.5 cpd
|
39.78 ± 17.95
|
39.29 ± 13.94
|
54.77 ± 37.16
|
0.003*
|
3 cpd
|
75.53 ± 41.95
|
76.79 ± 31.77
|
98.70 ± 49.19
|
0.015*
|
6 cpd
|
81.53 ± 51.91
|
78.84 ± 43.79
|
94.38 ± 45.30
|
0.118
|
12 cpd
|
27.98 ± 24.22
|
29.74 ± 23.47
|
44.05 ± 38.87
|
0.016*
|
18 cpd
|
10.85 ± 10.94
|
11.03 ± 6.96
|
12.54 ± 8.25
|
0.146
|
*p < 0.05, Kruskal Wallis test |