Investigation of chlorouine-induced keratopathy on in vivo confocal microscopy

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Investigation of chlorouine-induced keratopathy
on in vivo confocal microscopy

• Jianjiang Xu, Wenqing Zhu, Jiaxu Hong
• Eye ENT Hospital
• Fudan University
• Shanghai, China

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

• Paper ID 365
• Disclosure Block
• None of commercial relationships with authors.

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Outlines

• Background
• Objective
• Methods
• Results
• Conclusion

Eye ENT Hospital
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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
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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
Cornea
Stroma
Endothelium
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Objective

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

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Methods

• 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

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Results

• 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.

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Results

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

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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
• They might correspond to intracellular
  lysosome-like corpuscles which could not be
  metabolised
• Abnormal microenvironment on basal epithelial
  cells leads to a vicious cycle on the maturation
  of epithelial cells.

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Acknowledgement
Team 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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Thank you