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Visual Field Sensitivity Prediction Using Optical Coherence Tomography Analysis in Hydroxychloroquine Toxicity.

Gopal Jayakar1, Tharindu De Silva1, Catherine A Cukras1

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Long-term hydroxychloroquine (HCQ) use can impact vision. Retinal structure, measured by optical coherence tomography (OCT), strongly predicts visual function, aiding in understanding HCQ toxicity and outer retinal diseases.

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Area of Science:

  • Ophthalmology
  • Retinal Imaging
  • Pharmacological Toxicity

Background:

  • Hydroxychloroquine (HCQ) is widely used but can cause retinal toxicity.
  • Monitoring visual function and retinal structure is crucial for patients on long-term HCQ therapy.

Purpose of the Study:

  • To investigate the association between local retinal structure and visual function in patients with long-term HCQ use.
  • To determine if optical coherence tomography (OCT) metrics can predict visual field sensitivity.

Main Methods:

  • 84 participants with chronic HCQ use underwent spectral-domain OCT and Humphrey 10-2 visual fields.
  • OCT metrics (retinal thickness, minimum intensity, ellipsoid zone loss) were correlated with visual field test locations.
  • Multivariate random forest regression was used to predict visual field sensitivity.

Main Results:

  • Ellipsoid zone (EZ) loss showed the strongest correlation with parafoveal visual field sensitivity (R2=0.58).
  • Total and outer retinal thickness also correlated with visual sensitivity.
  • A multivariate model combining OCT metrics improved prediction (R2=0.66), with EZ loss being the most significant predictor.

Conclusions:

  • Quantitative OCT metrics, especially EZ loss, are valuable predictors of local visual function in HCQ users.
  • These findings enhance understanding of HCQ retinal toxicity.
  • The approach is applicable to developing outcomes for other outer retinal degenerative diseases.