Investigation of chlorouine-induced keratopathy on in vivo confocal microscopy

Jianjiang Xu, Wenqing Zhu, Jiaxu Hong

Eye & ENT HospitalFudan UniversityShanghai, China

Title: Investigation of chlorouine-induced keratopathy on in vivo confocal microscopy

Paper ID: 365

Disclosure Block: None of commercial relationships with authors.

Outlines

Background Objective Methods Results Conclusion

Eye & ENT Hospital

Background Chloroquine (CHQ) was used successfully for the

treatment of several chronic autoimmune diseases However, a variety of side effects have been

reported, of which ophthalmic toxicity is of the utmost importance.

Chloroquine Corneal Deposits

Background In vivo confocal microscopy(CM) has dramatically

changed the ophthalmic clinical landscape, allowing a non-invasive approach to in vivo visualize cornea at a magnification of up to ×700

50 µm

Epithelium EndotheliumStromaCornea

To investigate morphological changes of the cornea by CM in patients diagnosed as rheumatoid arthritis and treated with CHQ

Objective

Subjects•30 patients with rheumatoid arthritis were enrolled•20 were treated with CHQ•the rest served as control

Examination:•Bilateral eyes were examined by slitlamp biomicroscope and CM•CHQ deposits and corneal cellular densities were analyzed

Methods

Deposits•No deposit was observed

by SLB examination. •Under CM, CHQ deposits were

observed in 28 (70.0%) of 40

eyes in patients•CM deposits demonstrate different

characteristic features of the CHQ

between two groups.

Results

Cellular density•The cellular density of each layer had no significant difference between two groups except the density of anterior stromal keratocytes.

Results

Conclusion CM is a useful tool for the investigation of keratopathy

induced by CHQ treatment CHQ deposits were mainly identified in corneal epithelium

and stroma

① They might correspond to intracellular lysosome-like corpuscles which could not be metabolised

② Abnormal microenvironment on basal epithelial cells leads to a vicious cycle on the maturation of epithelial cells.

AcknowledgementTeam

Prof. Jianjiang Xu

Wenqing Zhu M.D.

Jiaxu Hong M.D.

Anji Wei M.D.

Gang Li Ph.D

Grants: This work was supported partly by grants from the Key Clinic Medicine Research Program, the Ministry of Health, China (2007-2009).

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