Abstract:
PURPOSE:To evaluate multifocal electroretinography (mfERG) as a screening test for detecting hydroxychloroquine and chloroquine toxicity. DESIGN:Diagnostic accuracy study. METHODS:Patients referred to the University of Ottawa for hydroxychloroquine or chloroquine retinopathy screening during 2011-2014 underwent 10-2 automated visual field, spectral domain optical coherence tomography, and mfERG testing. Patients with amblyopia, high myopia or hyperopia, coexisting retinal disease, or prior surgery were excluded. Abnormalities in parafoveal ring amplitudes or ring ratios were considered a positive mfERG result. We used the definition for hydroxychloroquine and chloroquine toxicity provided by the 2016 American Academy of Ophthalmology recommendations. Area under the curve (AUC) for each mfERG parameter and the sensitivity and specificity of mfERG were calculated. Logistic regression was used to model the effect of covariates in receiver operating characteristic (ROC) analyses. RESULTS:In total, 63 patients (47 female, 16 male) were included. Of 120 eyes, 16 (13.3%) had toxicity according to the American Academy of Ophthalmology guidelines, and 39 (32.5%) had positive mfERG findings. mfERG was found to have a sensitivity of 1.00 (95% CI 0.79-1.00) and a specificity of 0.78 (95% CI 0.69-0.85). Ring 2 amplitude had the best performance among all parameters (AUC 0.97, 95% CI 0.94-1.00). Ring 2 amplitude decreased linearly with increasing cumulative dose and daily dose. CONCLUSIONS:The high sensitivity of parafoveal depression on mfERG and its relationship to cumulative and daily dose illustrates an important role for objective functional testing. The high false-positive rate suggests a potential period where physiologic dysfunction is detected objectively on mfERG before structural change on spectral domain optical coherence tomography.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Tsang AC,Ahmadi S,Hamilton J,Gao J,Virgili G,Coupland SG,Gottlieb CCdoi
10.1016/j.ajo.2019.04.025subject
Has Abstractpub_date
2019-10-01 00:00:00pages
132-139eissn
0002-9394issn
1879-1891pii
S0002-9394(19)30206-5journal_volume
206pub_type
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
pub_type: 杂志文章,评审
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journal_title:American journal of ophthalmology
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更新日期:2005-12-01 00:00:00
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journal_title:American journal of ophthalmology
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pub_type: 杂志文章
doi:10.1016/s0002-9394(14)70402-7
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journal_title:American journal of ophthalmology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:American journal of ophthalmology
pub_type: 杂志文章
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
pub_type: 杂志文章
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pub_type: 杂志文章
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