scholarly journals AB0718 ASSESSMENT OF SEXUAL DYSFUNCTION IN WOMEN AND MEN WITH FIBROMYALGIA SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1390.2-1390
Author(s):  
G. Mouna ◽  
J. Mahbouba ◽  
S. Zrour ◽  
I. Bejia ◽  
M. Touzi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sexual Dysfunction ◽  
Sexual Health ◽  
Fibromyalgia Syndrome ◽  
Meta Analysis ◽  
Sexual Life ◽  
Cross Sectional ◽  
Female Patients ◽  
Significant Difference ◽  
Male Patients

Background:Fibromyalgia syndrome is a chronic musculoskeletal disease, which compromises physical, mental, and sexual health. Although concerns related to sexuality are commonly reported, the literature on sexual functioning in patient with fibromyalgia is limited to female patients.Objectives:The aim of our study is to identify sexual dysfunction in women and men with fibromyalgia syndrome compared with patients with rheumatoid arthritis.Methods:This is a cross-sectional comparative study: ‘34 patients with fibromyalgia syndrome compared to 100 patients with rheumatoid arthritis’ conducted in the rheumatology department of CHU Fattouma Bourguiba de Monastir over a period from February to November 2017. We used the Female Sexual Function Index (FSFI) and the Sexual Health Inventory for Men (SHIM).Results:Our sample comprised 34 patients with fibromyalgia (31 females and 3 males) and 100 patients with rheumatoid arthritis (58 females and 15 males).Sexual dysfunction was present in 100% of female patients with fibromyalgia syndrome compared to 60% of female patients with rheumatoid arthritis. Female patients with fibromyalgia syndrome had a decreased FSFI score: 10,3±8,74 versus 16,86±8,87 in the rheumatoid arthitis group with p=0.001. While among the male patients, we found no significant difference between the two groups.Conclusion:Fibromyalgia syndrome had negative side effect on the sexual life of female patients. Recognition of this dysfunction and its inclusion in the multidisciplinary management of fibromyalgia must be part of the treatment.References:[1]P. Romero-Alcalá et al., « Sexuality in male partners of womenwithfibromyalgiasyndrome: A qualitative study », PLoS One, vol. 14, no 11, nov. 2019, doi: 10.1371/journal.pone.0224990.[2]M. D. H. Besiroglu et M. D. M. Dursun, « The association betweenfibromyalgia and femalesexualdysfunction:asystematicreview and meta-analysis of observationalstudies », Int J ImpotRes, vol. 31, no 4, p. 288-297, juill. 2019, doi: 10.1038/s41443-018-0098-3.[3]T. M. Matarín Jiménez, C. Fernández-Sola, J. M. Hernández-Padilla, M. Correa Casado, L. H. Antequera Raynal, et J. Granero-Molina, « Perceptions about the sexuality of womenwithfibromyalgiasyndrome:aphenomenologicalstudy », J Adv Nurs, vol. 73, no 7, p. 1646-1656, juill. 2017, doi: 10.1111/jan.13262.[4]L. Bazzichiet al., « Fibromyalgia and sexualproblems », Reumatismo, vol. 64, no 4, p. 261-267, sept. 2012, doi: 10.4081/reumatismo.2012.261.Disclosure of Interests:None declared

scholarly journals Evaluation of sexual dysfunction and its predictive factors in female and male patients with rheumatoid arthritis

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Mohamed Azab ◽  
Maii Abdelraheem Abdellatif ◽  
Mai Mohamed Abdelnaby
Keyword(s):  
Rheumatoid Arthritis ◽  
Sexual Dysfunction ◽  
Disease Duration ◽  
Joint Disease ◽  
Female Patients ◽  
Number Of Children ◽  
Vas Score ◽  
Joint Deformity ◽  
Male Patients

Abstract Background Rheumatoid arthritis (RA) is a common disabling joint disease affecting both males and females. Sexual dysfunction (SD) is a common association with RA. The aim of this work was to study the prevalence and predictors of sexual dysfunction in male and female patients with rheumatoid arthritis. Results The mean age of female patients was 32.1 years and 39.7 years for males. The prevalence of sexual dysfunction was higher in RA female patients than controls, 62.1% versus 41.2% respectively (P ≤ 0.05). The prevalence of global sexual dysfunction was higher in RA male patients than controls, 63.8% versus 47.5% respectively (P ≤ 0.05). Predictors of sexual dysfunction in female RA patients were the number of children, BMI, disease duration, DAS score, HADs-D score, HAQ score, VAS score, joint deformity, and the number of drugs. Predictors of sexual dysfunction in male RA patients were age, disease duration, DAS score, HAQ score, VAS score, and the number of drugs. Conclusion SD is prevalent in RA patients. Disease activity, pain, depression, and disturbed quality of life affect nearly all domains of sexual functions in female and male patients.

SAT0327 SEXUAL DYSFUNCTION IN FEMALE SCLERODERMA PATIENTS AND ITS CORRELATION WITH VASCULAR INVOLVEMENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1109.1-1109
Author(s):  
Z. Khodamoradi ◽  
M. Nazarinia ◽  
E. Esmaeilzadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Sclerosis ◽  
Sexual Dysfunction ◽  
Vascular Complications ◽  
Vascular Involvement ◽  
P Value ◽  
Case Group ◽  
Digital Ulcers ◽  
Cross Sectional ◽  
Female Patients

Background:Systemic Sclerosis (Scleroderma, SSc) is an autoimmune disorder characterized by multi-organ dysfunction, which ultimately leads to multiple clinical and psychological complications. Among various complications of scleroderma, sexual dysfunction can be named as a major issue in both male and female patients, which has great impact on quality of life of the patients.Objectives:Investigating the sexual dysfunction in scleroderma patients and its relation to their vascular involvements.Methods:A case control study was done on 80 married female scleroderma patients with age between 20-60 years old. Eighty normal individuals adjusted for age, place of living and socioeconomic status were also recruited. Sexual performance in both groups was assessed using FSFI standardized questionnaire, which evaluated it in 6 domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. Micro and macro-vascular involvements of the patients were also determined using Raynaud Condition Score, Echocardiography, physical exam for assessing their digital ulcers and reviewing their medical records for presence of past or present history of renal crisis and thromboembolic events.Results:The total score of FSFI in the case group was significantly lower compared to control one (16.68 ± 6.35, 19.69 ± 6.01, P-value <0.001). The score was significantly lower in all domains of sexual dysfunction except for pain and lubrication. Moreover, the mean score of FSFI was also found to be significantly lower in limited form of the disease compared to diffuse one (14.6 ± 6.9, 18.1 ± 5.5, P-value 0.01). No significant association was found between vascular complications and sexual impairment of the scleroderma patients.Conclusion:This study can be named as the first survey investigating the sexual dysfunction in Iranian female scleroderma patients and assessing its relation with vascular complication of the disease. Thus, it can be a guide for future studies on sexual dysfunction especially in societies with cultural limitations in discussing this issue.References:[1]Bruni C, Raja J, Denton CP, Matucci-Cerinic M. The clinical relevance of sexual dysfunction in systemic sclerosis.Autoimmun Rev2015; 14(12):1111-5. doi: 10.1016/j.autrev.2015.07.016.[2]Puchner R, Sautner J, Gruber J, Bragagna E, Trenkler A, Lang G. et al. High Burden of Sexual Dysfunction in Female Patients with Rheumatoid Arthritis: Results of a Cross-sectional Study.J Rheumatol2019; 46(1):19-26. doi: 10.3899/jrheum.171287.[3]Lin MC, Lu MC, Livneh H, Lai NS, Guo HR, Tsai TY. Factors associated with sexual dysfunction in Taiwanese females with rheumatoid arthritis.BMC Womens Health2017; 17(1):12. doi: 10.1186/s12905-017-0363-5.[4]Frikha F, Masmoudi J, Saidi N, Bahloul Z. Sexual dysfunction in married women with Systemic Sclerosis.Pan Afr Med J2014; 17:82. doi: 10.11604/pamj.2014.17.82.3833.Disclosure of Interests:None declared

Influence of 5-HTR2C Polymorphisms on Metabolic Syndromes in Thai Schizophrenia Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S168-S168
Author(s):  
A. Puangpetch ◽  
C. Na Nakorn ◽  
W. Unaharassamee ◽  
C. Sukasem
Keyword(s):  
Metabolic Syndrome ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
Nucleotide Polymorphisms ◽  
Cross Sectional ◽  
Female Patients ◽  
The Metabolic Syndrome ◽  
Significant Difference ◽  
Male Patients ◽  
Competing Interest

IntroductionMetabolic syndrome is a significant problem in the schizophrenia patients. Previous research demonstrated that single nucleotide polymorphisms in the serotonin 2C receptor (5HTR2C) genes are associated with metabolic syndrome related to schizophrenia patients taking atypical anti-psychotic drugs. This study aimed to investigate whether the effect of 3 SNPs in 5HTR2C gene on the presence of the metabolic syndrome in Thai schizophrenia patients.MethodWe conducted a cross-sectional study and 154 patients were recruited. The schizophrenia patients were identified from a diagnostic and statistical manual of mental disorders, 4th edition, (DSM-IV) and criterion and determined the metabolic syndrome according to the 2005 international diabetes federation (IDF) Asia criteria. Patients were genotyped for the 5HTR2C rs51,8147, rs126,881,02, rs128,367,71 polymorphisms.ResultsThe preliminary analysis from 154 patients showed the metabolic syndrome prevalence was 38.73%, with 46.50% in male and 53.48% in female patients. The results showed that the patients who have heterozygous and homozygous variant on 5HTR2C gene (rs518,147 and rs126,881,02) showed a significant difference in the presence of metabolic syndrome when compare with patients who carry homozygous wild type (P = 0.007), especially in male patients (P = 0.002). The association between 5HTR2C polymorphisms and metabolic syndrome was found in male patients but not found in female patients.ConclusionThese findings suggest that 5HTR2C genotypes are associated with the metabolic syndrome in patients taking atypical anti-psychotics. However, the metabolic syndrome results from the multigenetic effects. The further studies should focus on the other genes, which were involved in metabolic syndrome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals High Burden of Sexual Dysfunction in Female Patients with Rheumatoid Arthritis: Results of a Cross-sectional Study

2018 ◽  
Vol 46 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Rudolf Puchner ◽  
Judith Sautner ◽  
Johann Gruber ◽  
Elia Bragagna ◽  
Andrea Trenkler ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sexual Dysfunction ◽  
Disease Activity ◽  
Sexual Functioning ◽  
Activity Index ◽  
Short Form ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Cross Sectional ◽  
Female Patients

Objective.To evaluate the effect of rheumatoid arthritis (RA) on impairing women’s sexuality regarding motivation, activity, and satisfaction, and to assess the correlation of disease-related physical impairment within sexual functioning.Methods.An anonymous survey among women with RA and healthy controls (HC) using standardized questionnaires, predominantly the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14). In addition, disease activity, depression, and disability were evaluated.Results.There were 319 questionnaires distributed to patients and 306 to HC. Of these, 235 patient questionnaires (73.7%) and 180 HC questionnaires (58.8%) were returned, of which 203 and 169 were completed, respectively. Of the patients with RA, 47.8% had a total CSFQ-14 score of ≤ 41, indicating female sexual dysfunction (FSD), as compared to 14.2% of HC (p < 0.0001). The median CSFQ-14 score was lower in patients with RA [42 points, interquartile range (IQR) 36–48] than in HC (49 points, IQR 44–54; p < 0.0001), resulting in an OR of 5.53 (95% CI 3.19–9.57; p < 0.0001). After adjustment for confounders, given a higher mean age of patients (55.2 ± 11.3 yrs) than HC (47.4 ± 11.8 yrs; p < 0.0001), the OR for FSD in patients with RA was still 3.04 (95% CI 1.61–5.75; p = 0.001). Neither the Health Assessment Questionnaire–Disability Index nor the Clinical Disease Activity Index was associated with FSD after adjustment.Conclusion.FSD apparently is highly prevalent in female patients with RA, affects all subdomains of sexual function, and is most likely underestimated in daily clinical practice. Of note, FSD could not be linked to disability or RA disease activity.

scholarly journals THE DIFFERENCES OF CHRONOLOGICAL AGE WITH DENTAL AGE BASED ON THE ALQAHTANI METHODE AGED 6-12 YEARS

2021 ◽  
Vol 1 (Volume 1 No 1) ◽  
pp. 60-70
Author(s):  
Mutiara Sukma Suntana ◽  
Ira Artilia ◽  
Lucy Pertiwi
Keyword(s):  
Wilcoxon Test ◽  
Chronological Age ◽  
Sufficient Information ◽  
Dental Age ◽  
Research Subjects ◽  
Cross Sectional ◽  
Panoramic Radiographs ◽  
Female Patients ◽  
Significant Difference ◽  
Male Patients

The chronological age of a person can not provide sufficient information. We can use the dental age in panoramic radiographs to know the growth process appropriately compared to The London Atlas of the Alqahtani method. Children aged 6-12 years have various factors that can affect the velocity in tooth growth and development, such as male and female. This study aims to determine the chronological patient's age differences with dental age based on the Alqahtani method on a panoramic radiograph at Unjani Dental and Oral Education Hospital. This type of research is Analytical Observational with the Cross-Sectional Study method. Research subjects were obtained from all medical records panoramic radiographs with 72 panoramic radiographs aged 6-12 years, divided into 36 male patients and 36 female patients. Differences in chronological age with dental age were analyzed statistically using the Mann-Whitney test and Wilcoxon test, previously tested for the normality using Kolmogorov- Smirnov. The results showed a significant difference between chronological age and dental age by gender and in all patients at the Unjani Dental and Oral Education Hospital (p<0,05). Based on the analysis of the data obtained, all patients in RSGMP Unjani aged 6-12 years have different dental developmental growth processes, and the dental development growth of female patients was faster than male patients. It can be concluded that the dental age is not always comparable with chronological age because of various factors such as gender, genetics and environment, which can affect the dental age.

scholarly journals Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Tender Joint ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean ◽  
Anti Inflammatory

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

Low Level of Serum Sclerostin in Adult Patients with Tumor-induced Osteomalacia Comparing with X-linked Hypophosphatemia

2021 ◽  
Author(s):  
Xiaolin Ni ◽  
Qi Zhang ◽  
Xiang Li ◽  
Qianqian Pang ◽  
Yiyi Gong ◽  
...  
Keyword(s):  
Bone Mass ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Significant Difference ◽  
Healthy Control ◽  
Premenopausal Patients ◽  
Male Patients ◽  
Sclerostin Level ◽  
Sclerostin Antibody

Abstract Context Sclerostin is an inhibitor of Wnt-β-catenin signaling to regulate bone formation. Circulating sclerostin levels were reported to be elevated in patients with X-linked hypophosphatemia (XLH), and sclerostin antibody (Scl-Ab) has been shown to increase bone mass and normalize circulating phosphate levels in Hyp mice. However, circulating sclerostin level in acquired hypophosphatemic patients with tumor-induced osteomalacia (TIO) remains rare reported. Objectives This study was designed to evaluate serum sclerostin levels in TIO patients comparing them with age-, sex- matched healthy controls and XLH patients, and analyze correlation of circulating sclerostin with BMD and laboratory parameters. Design, Setting and Participants 190 individuals including 83 adult TIO patients, 83 adult healthy controls and 24 adult XLH patients were enrolled in this cross-sectional study. Main outcome measures Serum sclerostin levels were determined in TIO patients, healthy controls and XLH patients. Results TIO patients (43 male and 40 female) aged 44.3 ± 8.7 (mean ± SD) years had lower levels of circulating sclerostin than healthy controls (94.2 ± 45.8 vs 108.4 ± 42.3 pg/mL, p = 0.01) with adjustment for age, gender, BMI and diabetes rate. Sclerostin levels were positively associated with age (r = 0.238, p = 0.030). Male patients had higher sclerostin level than female patients (104.7 ± 47.3 vs 83.0 ± 41.8 pg/mL, p = 0.014) and postmenopausal patients had higher tendency of sclerostin level than premenopausal patients (98.4 ± 48.8 vs 71.6 ± 32.3 ng/ml, p = 0.05). Sclerostin levels were positively associated with BMD of L1-4 (r = 0.255, p = 0.028), femoral neck (r = 0.242, p = 0.039) and serum calcium (r = 0.231, p = 0.043). TIO subgroup patients (n=24, 35.9 ± 7.3 years old) comparing with age-, sex-matched adult XLH patients and healthy controls revealed significant difference of sclerostin levels (XLH, TIO and healthy control were 132.0 ± 68.8, 68.4 ± 31.3 and 98.6 ± 41.1 pg/mL, respectively, p &lt; 0.001). Conclusions Circulating sclerostin levels were decreased in TIO patients but increased in XLH patients, which might be result of histological abnormality and bone mass.

Evaluation of the Fibromyalgia and Related Risk Factors in Patients with Advanced Kidney Failure Undergoing Hemodialysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Seyed Mostafa Seyedmardani ◽  
Saeed Abkhiz ◽  
Azadeh Megrazi ◽  
Aarefeh Jafarzade ◽  
Golshan Kamali Zonouz
Keyword(s):  
Risk Factors ◽  
Kidney Failure ◽  
Fibromyalgia Syndrome ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Age And Gender ◽  
Significant Difference ◽  
Symptom Severity Score ◽  
And Gender

Background : Fibromyalgia syndrome (FMS) is defined as widespread and persistent pain in the musculoskeletal system. There are limited reports regarding the prevalence of fibromyalgia syndrome in patients with advanced kidney failure undergoing regular hemodialysis. Therefore, this study aimed to evaluate the prevalence of fibromyalgia syndrome and its risk factors in a large proportion of patients under the hemodialysis condition. Materials and Methods: In this cross-sectional study, 293 patients who were admitted to the hemodialysis ward were evaluated for fibromyalgia syndrome in an educational hospital. The questionnaire was designed according to symptom severity score (SS score) and widespread pain index (WPI) criteria. The correlation between FMS and various variables, including demographic, clinical, and biochemistry biomarkers, was also precisely calculated by logistic regression. Data were analyzed using SPSS v.17 statistics software. Results: The results showed that, of 293 hemodialysis patients, 130 patients (44.4%) had fibromyalgia, the mean age of patients with and without fibromyalgia was 61.09 ± 15.36 and 53.49 ± 15.38 years old, respectively (P = 0.001). Moreover, there was a significant difference in terms of gender among patients with fibromyalgia syndrome (P = 0.001). To note, there was no significant relationship between the kidney failure etiopathogenesis, duration of dialysis, body mass index (BMI), Kt/v index, history of peritoneal dialysis, and laboratory parameters with fibromyalgia in hemodialysis patients (P > 0.05). However, our findings revealed that both age and gender could be considered as the predictor variables associated with fibromyalgia in patients undergoing hemodialysis. Conclusion: Taken together, in this study, we found that age and gender would be the critical factors in terms of the fibromyalgia syndrome in patients undergoing hemodialysis.

scholarly journals Detection of Hydroxychloroquine Retinal Toxicity by Automated Perimetry in 60 Rheumatoid Arthritis Patients with Normal Fundoscopic Findings

2015 ◽  
Vol 8 (3) ◽  
pp. 59 ◽  
Author(s):  
Qader Motarjemizadeh ◽  
Naser Samadi Aidenloo ◽  
Mohammad Abbaszadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Detection ◽  
Anterior Segment ◽  
Field Testing ◽  
Retinal Toxicity ◽  
Screening Tests ◽  
Automated Perimetry ◽  
Cross Sectional ◽  
Dry Eyes ◽  
Significant Difference

<p>Hydroxychloroquine (HCQ) is an antimalarial drug used extensively in treatment of autoimmune diseases such as rheumatoid arthritis. Retinal toxicity is the most important side effects of this drug. Even after the drug is discontinued, retinal degeneration from HCQ can continue to progress. Consequently, multiple ophthalmic screening tests have been developed to detect early retinopathy. The aim of the current study was to evaluate the value of central 2-10 perimetry method in early detection of retinal toxicity. This prospective cross-sectional investigation was carried out on 60 rheumatoid arthritis patients, who had been receiving HCQ for at least 6 months and still were on their medication (HCQ intake) at the time of enrollment. An ophthalmologist examined participants using direct and indirect ophthalmoscopy. Visual field testing with automated perimetry technique (central 2-10 perimetry with red target) was performed on all included subjects twice in 6 months interval: The first one at the time of enrollment and the second one 6 months later. Males and females did not show any significant difference in terms of age, duration of therapy, daily and cumulative HCQ dose, anterior or posterior segment abnormalities, hypertension, body mass index, and best corrected visual acuity. Anterior segment was abnormal in 9 individuals including 3 subjects with macular pigmentary changes, 4 individuals with cataract and 2 cases with dry eyes. Moreover, 12 subjects had retinal pigmented epithelium (RPE) in their posterior segments. After 6 months, depressive changes appeared in 12 subjects. Additionally, HCQ therapy worsened significantly the perimetric results of 5 (55.6%) patients with abnormal anterior segment. A same trend was observed in perimetric results of 6 (50.0%) subjects with abnormal posterior segments (P=0.009). The daily dose of HCQ (P=0.035) as well as the cumulative dose of hydroxychloroquine (P=0.021) displayed statistically significant associations with perimetric results. Central 2-10 perimetry is a useful method for early detection of HCQ retinal toxicity, but more comprehensive studies, with larger sample size, longer-term follow-up and more precise techniques are mandatory to confirm HCQ retinal toxicity.</p>

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