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Updated: Jun 5, 2026
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Multifocal Electroretinograms
Published on: December 4, 2011
Retinal functional changes measured by frequency-doubling technology in patients treated with hydroxychloroquine
Lucia Tanga1, Marco Centofanti, Francesco Oddone
1Fondazione G.B. Bietti for Study and Research in Ophthalmology, IRCCS, Via Livenza 3, Rome, Italy. luciatanga@libero.it
Summary
Frequency Doubling Perimetry (FDP) can detect early retinal damage in patients taking hydroxychloroquine (HCQ). This method identifies visual field defects before other clinical signs appear, aiding in the monitoring of HCQ-treated patients.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) and chloroquine (CQ) are used for rheumatologic diseases but can cause irreversible retinal toxicity.
- Early paracentral visual field loss is an indicator of HCQ toxicity, preceding changes in visual acuity or fundoscopy.
- The exact mechanism of CQ retinal toxicity is not fully understood.
Purpose of the Study:
- To investigate early retinal functional changes using Frequency Doubling Technology (FDT) in patients undergoing HCQ treatment.
- To assess the utility of FDT in detecting subclinical retinal impairment.
Main Methods:
- A cross-sectional, prospective study involving 48 eyes of HCQ-treated patients without signs of toxicity and 36 healthy controls.
- Functional testing included Frequency Doubling Humphrey-Matrix Perimetry (FDP), standard Humphrey Visual Field (HFA) perimetry (24-2 and 10-2), multifocal electroretinogram (mfERG), and contrast sensitivity (CS).
Main Results:
- FDP revealed significantly reduced mean deviation (MD) and worse pattern standard deviation (PSD) in HCQ patients compared to controls in both 24-2 and 10-2 programs.
- Humphrey Visual Field (HFA) PSD and contrast sensitivity (CS) were also significantly reduced in HCQ patients.
- A significant difference in the ratio of retinal response amplitude densities (RAD) between central and paracentral regions was observed.
Conclusions:
- Frequency Doubling Perimetry (FDP) is a valuable tool for detecting early, subclinical retinal functional impairment in patients treated with hydroxychloroquine (HCQ).
- FDP can identify visual field defects before they become clinically apparent, aiding in proactive patient management and prevention of irreversible damage.
