Chloroquine keratopathy of rheumatoid arthritis patients detected by in vivo confocal microscopy.

Abstract:

AIM:To investigate microscopic changes in corneal morphology in chloroquine (CQ)-treated patients without corneal abnormalities being diagnosable by slit lamp microscopy. METHODS:Thirty-six eyes of 36 patients with rheumatoid arthritis (RA) were divided into two groups: group 1 included 26 patients receiving chloroquine therapy; group 2 included the other 10 patients, not receiving chloroquine therapy. The control group included 15 healthy subjects. Best spectacle-corrected visual acuity (BSCVA), intraocular pressure (IOP) and slit lamp microscopy and in vivo confocal microscopy examinations were performed on all subjects. RESULTS:In group 1, hyperreflective abnormal particles were found in different layers of the cornea in 19 (75%) of 26 eyes by confocal microscopy. The deposits were present within the superficial epithelium (14/19), basal epithelium (8/19) and anterior stroma (5/19). In both RA groups, more beaded and tortuous fibers were seen in the sub-basal corneal nerve bundles, and the sub-epithelial and stromal nerves had much more branches, than did normal controls. The anterior keratocyte density in group 1 was lower than in group 2 (P < 0.05) and the number of sub-basal nerves was larger than in group 2 (P < 0.05). Cumulative dosage had a statistically significant correlation with anterior keratocyte density, the number of sub-basal nerves and the density of abnormal particles. CONCLUSION:Corneal microdeposits are an important manifestation of chloroquine-induced keratopathy. Corneal stroma cell density and corneal nerve number and morphology changes are also useful for detecting early chloroquine-induced keratopathy. This would be proved in our future longitudinal studies.

journal_name

Curr Eye Res

journal_title

Current eye research

authors

Ma X,He L,He D,Xu J

doi

10.3109/02713683.2011.631719

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

293-9

issue

4

eissn

0271-3683

issn

1460-2202

journal_volume

37

pub_type

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