Role of optical coherence tomography angiography in detecting possible retinal vascular complications of sofosbuvir and daclatasvir in patients with hepatitis C virus infection

• Main Authors: Hany E Elmekkawy, Mohamed S Emam, Magda S Abdelaziz, Mai I Mehrez, Yomna A Alahmadawy
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Delta Journal of Ophthalmology
• Subjects: antiviral therapy; hepatitis c; optical coherence tomography angiography; retinal microvasculature
• Online Access: http://www.djo.eg.net/article.asp?issn=1110-9173;year=2021;volume=22;issue=2;spage=132;epage=141;aulast=Elmekkawy

Purpose The aim of this study was to evaluate the value of optical coherence tomography angiography (OCTA) in the detection of any suspected retinal complications associated with the use of combined therapy (sofosbuvir ‘Sovaldi’ and daclatasvir ‘Daklinza’) in patients with hepatitis C virus infection. Patients and methods This is a prospective cohort study that enrolled patients with chronic hepatitis C who did not receive any previous antiviral treatment and who were candidates for the dual therapy. During a 3-month duration (the treatment course duration), OCTA was performed for documented chronic hepatitis C-infected patients before and after receiving the dual therapy (daclatasvir–sofosbuvir). The minimum outcome measures were best-corrected visual acuity and vascular density by OCTA macula. Results There was a statistically significant reduction in the deep capillary plexus (P≤0.05). The whole macular vessel density was reduced from 51.56 to 47.68% after the treatment course (P=0.04). These vascular density changes were associated with statistically insignificant increase in thickness. In addition, the choriocapillaris had a statistically significant reduction in flow area from 2.145 to 2.063 mm2 (P=0.0001). The superficial capillary plexus changes in vessel density were statistically insignificant except at the temporal parafoveal area. There was also a statistically significant reduction in the foveal avascular zone flow density from 54.42% before starting the dual therapy course to 51.85% after finishing it (P=0.022). These changes were associated with a statistically significant reduction in best-corrected visual acuity from 0.83 to 0.63 (P<0.001) and a statistically significant development of macular drusen (P=0.004). Conclusions Hepatitis C virus dual treatment (sofosbuvir and daclatasvir) may result in significant changes affecting the retinal microvasculature.