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Multifocal electroretinography evaluation for early detection of retinal dysfunction in patients taking
Philip J Penrose1, Radouil T Tzekov, Erich E Sutter
1Department of Ophthalmology, California Pacific Medical Center, PO Box 7999, San Francisco, CA 94120, USA. philip@ski.org
Retina (Philadelphia, Pa.)
|September 16, 2003
Summary
Multifocal electroretinography (mfERG) detected reduced retinal function in asymptomatic hydroxychloroquine users, suggesting potential preclinical toxicity. These findings highlight mfERG
Area of Science:
- Ophthalmology
- Neuroscience
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is widely used for autoimmune conditions.
- HCQ retinopathy is a known, potentially irreversible complication.
- Early detection of HCQ toxicity is crucial for preserving vision.
Purpose of the Study:
- To assess macular function in asymptomatic HCQ users using multifocal electroretinography (mfERG).
- To identify potential preclinical signs of HCQ maculopathy.
- To evaluate mfERG's utility in detecting subtle retinal dysfunction.
Main Methods:
- mfERG recordings were performed on 11 asymptomatic HCQ users and 1 patient with known HCQ maculopathy.
- Standard m-sequence paradigm (first-order kernel) and a novel MF0F0 paradigm (second-order effects) were employed.
- Retinal responses were analyzed for areas of decreased function in both eyes.
Main Results:
- The patient with toxic maculopathy showed reduced retinal responses.
- One asymptomatic patient also exhibited bilateral decreased responses on the classic m-sequence.
- mfERG's second-order component (MF0F0) revealed decreased function in the toxic patient and three asymptomatic patients, with reproducible findings on retesting.
Conclusions:
- Substantial local decreases in retinal function can occur in clinically asymptomatic HCQ users.
- mfERG alterations may indicate a preclinical stage of HCQ-related retinal toxicity.
- mfERG is a valuable tool for monitoring HCQ users and detecting early signs of retinopathy.