SDÜ Tıp Fakültesi, Göz Hastalıkları A.D., Isparta

Purpose: To evaluate early stage alterations in macular functions following systemic use of hydroxychloroquine. Materials and Methods: This study included 52 eyes of 26 patients that were undergoing systemic hydroxychloroquine therapy for systemic lupus erithematosus (n=4) and rheumatoid arthritis (n=22). Macular functions were evaluated by detecting visual acuity, reading acuity, contrast sensitivity and macular threshold before and after the systemic use of hydroxychloroquine treatment (400 mg/day). Results: The average age of the patients were 42±2 (±SEM). There was no difference between baseline and final values of distance visual acuity (0.05±0.02 [logMAR] versus 0.05±0.02, P=1) and reading visual acuity (0.05±0.04 versus 0.05±0.04, P=1). Contrast sensitivity deteriorated from 1.26±0.03 [logCS] to 1.23±0.03 (P<0.01) at 2nd month, and stayed deteriorated till 4th month (1.19±0.03, P<0.01). Macular threshold deterioration detected by redon- white test was first noted at 2nd month [6.09±0.84 dB versus 8.05±0.88 dB (P<0.01)] whereas macular threshold deterioration detected by blue-on-yellow test could be appreciated as the early as first month [(6.44±0.84 dB versus 7.09±0.93 (P=0.015)]. Conclusion: Contrast sensitivity and macular threshold tests can detect the earliest subtle changes of macular functions while visual acuity is still normal in patients on systemic hydroxychloroquine therapy.