Photoreceptor Outer Segment Reflectivity With Ultrahigh-Resolution Visible-Light Optical Coherence Tomography in Systemic Hydroxychloroquine Use.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Translational Vision Science & Technology Pub Date : 2025-03-03 DOI:10.1167/tvst.14.3.2

Anupam K Garg, Jingyu Wang, Bailee Alonzo, Ji Yi, Amir H Kashani

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Abstract

Purpose: To evaluate outer retinal organization in normal subjects and those using hydroxychloroquine (HCQ) with ultrahigh-resolution visible-light optical coherence tomography (VIS-OCT).

Methods: Forty eyes of 22 adult subjects were recruited from a tertiary-care retina practice, including controls (20 eyes, 12 subjects, 40 ± 22 years old) and subjects with a history of HCQ use (20 eyes, 10 subjects, 62 ± 17 years old). Each subject was imaged using a custom-built VIS-OCT device (axial resolution 1.3 µm) and U.S. Food and Drug Administration-approved OCT devices.

Results: With the use of VIS-OCT, control subjects demonstrated five and six hyperreflective bands in the foveal and parafoveal regions, respectively, between the outer nuclear layer and Bruch's membrane. These bands demonstrated intensity profiles complementary to the known histopathologic distribution of rods and cones. In comparison to controls, subjects taking HCQ demonstrated reduced intensity of all bands, particularly bands two to four. In all cases of suspected or known toxicity, VIS-OCT demonstrated attenuation of band 3i, and in no cases was there attenuation of other bands that was more severe than band 3i, suggesting that changes in the reflectivity of band 3i may be the earliest identifiable sign of HCQ toxicity.

Conclusions: VIS-OCT of the outer retina revealed a unique outer retinal banding pattern corresponding to photoreceptor density distributions. Notable attenuation of the photoreceptor outer segment reflectivity profile was associated with early HCQ toxicity. This finding may be an early, and possibly reversible, sign of HCQ toxicity, primarily impacting the cones.

Translational relevance: VIS-OCT is useful in detecting subclinical outer retinal structural changes found in subjects using hydroxychloroquine.

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用超高分辨率可见光相干层析成像在全身羟氯喹使用中的光感受器外段反射率。

目的：应用超高分辨率可见光相干断层扫描（VIS-OCT）评价正常受试者和羟氯喹（HCQ）患者的视网膜外组织。方法：从一家三级视网膜诊所招募了22名成年受试者的40只眼睛，包括对照组（20只眼睛，12名受试者，40±22岁）和有HCQ使用史的受试者（20只眼睛，10名受试者，62±17岁）。每个受试者使用定制的VIS-OCT设备（轴向分辨率1.3µm）和美国食品和药物管理局批准的OCT设备进行成像。结果：通过VIS-OCT，对照组在核外层和布鲁氏膜之间的中央凹区和中央凹旁区分别显示出5条和6条高反射带。这些条带显示的强度分布与已知的视杆细胞和视锥细胞的组织病理学分布相辅相成。与对照组相比，服用HCQ的受试者表现出所有波段的强度降低，特别是2至4波段。在所有怀疑或已知的毒性病例中，VIS-OCT均显示3i波段衰减，而没有任何其他波段的衰减比3i波段更严重，这表明3i波段反射率的变化可能是HCQ毒性的最早可识别迹象。结论：外视网膜的VIS-OCT显示出独特的视网膜外带状模式，与光感受器密度分布相对应。光感受器外段反射率谱的显著衰减与早期HCQ毒性有关。这一发现可能是HCQ毒性的早期迹象，可能是可逆的，主要影响视锥细胞。翻译相关性：VIS-OCT可用于检测使用羟氯喹受试者的亚临床视网膜外结构变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.