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Multifocal Electroretinograms
Published on: December 4, 2011
Humphrey visual field findings in hydroxychloroquine toxicity
C Anderson1, G R Blaha, J L Marx
1Department of Ophthalmology, Lahey Clinic, Peabody, MA 01960, USA. Carolyn.Anderson@Lahey.org
Eye (London, England)
|November 19, 2011
Summary
Humphrey visual field (HVF) testing can detect early hydroxychloroquine (HCQ) retinal toxicity, often before fundus changes appear. Subtle HVF abnormalities may indicate toxicity years before clinical diagnosis.
Area of Science:
- Ophthalmology
- Retinal Toxicology
Background:
- Hydroxychloroquine (HCQ) is widely used for autoimmune conditions.
- HCQ retinopathy poses a risk of vision loss.
- Early detection of HCQ toxicity is crucial for preserving vision.
Purpose of the Study:
- To analyze Humphrey visual field (HVF) findings in patients with hydroxychloroquine (HCQ) retinal toxicity.
- To determine if early diagnosis of HCQ toxicity is possible through HVF analysis.
Main Methods:
- Retrospective observational case series of 15 patients with diagnosed HCQ toxicity.
- Review of 66 HVF tests, excluding patients with confounding visual field loss.
- Analysis of pre-diagnosis HVFs to assess for earlier detection potential.
Main Results:
- Subtle abnormalities were noted on HVF tests, varying with test type (e.g., 10-2 vs. 24-2).
- Pattern deviation plots were more sensitive than grayscale for detecting abnormalities.
- Fifty percent of patients with prior HVFs showed abnormalities indicative of HCQ toxicity months to years before diagnosis.
- HVF changes preceded fundus changes in nine patients.
Conclusions:
- HVF abnormalities in HCQ toxicity are diverse and depend on the specific test used.
- Clinicians must recognize the subtle nature of early HCQ toxicity on HVF.
- HVF testing can be a valuable tool for early detection of HCQ retinopathy.
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