A novel 5-ring multifocal electroretinography stimulus for detecting hydroxychloroquine retinal toxicity

Area of Science:

• Ophthalmology
• Neuroscience
• Toxicology

Background:

• Multifocal electroretinogram (mfERG) is valuable for detecting early hydroxychloroquine (HCQ) retinopathy.
• Current mfERG protocols are limited by accessibility and long testing times, hindering widespread clinical adoption.
• HCQ retinopathy screening is crucial due to the drug's potential ocular toxicity.

Purpose of the Study:

• To evaluate a novel concentric 5-ring mfERG stimulus for a simplified and rapid HCQ toxicity screening protocol.
• To compare the efficacy and time efficiency of the 5-ring mfERG protocol against the standard 61-hexagon mfERG stimulus.

Main Methods:

• An observational cross-sectional study involving 52 patients undergoing HCQ retinopathy screening.
• Comparison of a novel 5-ring mfERG protocol with a standard 61-hexagon mfERG protocol.
• Assessment of test completion time and correlation of mfERG ring ratios with HCQ dosage and duration.

Main Results:

• The 5-ring mfERG protocol was significantly faster (1.3 min) than the 61-hexagon protocol (5.2 min).
• The R2/R5 ring ratio from the 5-ring protocol showed moderate correlations with daily, cumulative HCQ dose, and therapy duration.
• The 5-ring protocol's R2/R5 ring ratio demonstrated stronger correlations with daily and cumulative HCQ doses compared to the 61-hexagon stimulus.

Conclusions:

• The novel 5-ring mfERG protocol significantly reduces data acquisition time for HCQ retinopathy screening.
• This rapid mfERG protocol provides comparable results to the standard 61-hexagon stimulus for detecting HCQ-induced electrophysiological changes.
• The 5-ring mfERG protocol offers potential for increased clinical practicality in routine screening for HCQ toxicity.