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Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy.
Transl Vis Sci Technol 2019; 8(5):19TV

Abstract

Purpose

To compare retinal function by using fundus-guided microperimetry (MP) and multifocal electroretinography (mfERG) for detecting hydroxychloroquine (HCQ) maculopathy.

Methods

Forty-six eyes of 25 patients referred to our clinical practice for HCQ maculopathy assessment and 3 groups of normal control subjects were evaluated by mfERG and MP. Macular structure was assessed using spectral-domain optical coherence tomography (SD-OCT). Ring ratios from the three innermost mERG rings were compared with average sensitivity of each MP ring at approximately equivalent distances from the fovea. HCQ toxicity was defined as an mfERG ring ratio or mean MP ring sensitivity >2 standard deviations below the normal mean. The sensitivity and specificity of MP to detect HCQ toxicity relative to mfERG were evaluated.

Results

MP rings MR2 and MR3 were positively correlated with corresponding mfERG ring ratios (r = 0.52, P = 0.002 and r = 0.56, P < 0.001 respectively). Ring 2 and ring 3 measures of MP and mfERG were significantly worse in HCQ eyes than controls (P < 0.001). The sensitivity of MP to detect toxicity for MR1 through MR3 ranged from 33% to 88%, whereas specificity ranged from 72% to 85%. Through rings 1 to 3, the frequency of abnormal function ranged from 20% to 48% for MP, 11% to 35% for mfERG, and 41% to 45% for SD-OCT.

Conclusions

The frequency of detection of HCQ toxicity with MP was greater than with mfERG. MP showed an overall good sensitivity and moderate specificity in detecting HCQ-induced functional deficits.

Translational Relevance

Results from this study may allow clinicians to improve screening accuracy for HCQ toxicity by using the alternative modality of MP.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31602344

Citation

Alghanem, Husam, et al. "Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy." Translational Vision Science & Technology, vol. 8, no. 5, 2019, p. 19.
Alghanem H, Padhi TR, Chen A, et al. Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy. Transl Vis Sci Technol. 2019;8(5):19.
Alghanem, H., Padhi, T. R., Chen, A., Niziol, L. M., Abalem, M. F., Dakki, N., ... Khan, N. W. (2019). Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy. Translational Vision Science & Technology, 8(5), p. 19. doi:10.1167/tvst.8.5.19.
Alghanem H, et al. Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy. Transl Vis Sci Technol. 2019;8(5):19. PubMed PMID: 31602344.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Fundus-Guided Microperimetry and Multifocal Electroretinography for Evaluating Hydroxychloroquine Maculopathy. AU - Alghanem,Husam, AU - Padhi,Tapas R, AU - Chen,Adrienne, AU - Niziol,Leslie M, AU - Abalem,Maria Fernanda, AU - Dakki,Natalie, AU - Steffens,Timothy, AU - Andrews,Chris, AU - Musch,David C, AU - Jayasundera,K Thiran, AU - Khan,Naheed W, Y1 - 2019/09/27/ PY - 2019/06/20/received PY - 2019/06/29/accepted PY - 2019/10/12/entrez PY - 2019/10/12/pubmed PY - 2019/10/12/medline KW - Plaquenil KW - hydroxychloroquine KW - microperimetry KW - multifocal electroretinography KW - ring ratio SP - 19 EP - 19 JF - Translational vision science & technology JO - Transl Vis Sci Technol VL - 8 IS - 5 N2 - Purpose: To compare retinal function by using fundus-guided microperimetry (MP) and multifocal electroretinography (mfERG) for detecting hydroxychloroquine (HCQ) maculopathy. Methods: Forty-six eyes of 25 patients referred to our clinical practice for HCQ maculopathy assessment and 3 groups of normal control subjects were evaluated by mfERG and MP. Macular structure was assessed using spectral-domain optical coherence tomography (SD-OCT). Ring ratios from the three innermost mERG rings were compared with average sensitivity of each MP ring at approximately equivalent distances from the fovea. HCQ toxicity was defined as an mfERG ring ratio or mean MP ring sensitivity >2 standard deviations below the normal mean. The sensitivity and specificity of MP to detect HCQ toxicity relative to mfERG were evaluated. Results: MP rings MR2 and MR3 were positively correlated with corresponding mfERG ring ratios (r = 0.52, P = 0.002 and r = 0.56, P < 0.001 respectively). Ring 2 and ring 3 measures of MP and mfERG were significantly worse in HCQ eyes than controls (P < 0.001). The sensitivity of MP to detect toxicity for MR1 through MR3 ranged from 33% to 88%, whereas specificity ranged from 72% to 85%. Through rings 1 to 3, the frequency of abnormal function ranged from 20% to 48% for MP, 11% to 35% for mfERG, and 41% to 45% for SD-OCT. Conclusions: The frequency of detection of HCQ toxicity with MP was greater than with mfERG. MP showed an overall good sensitivity and moderate specificity in detecting HCQ-induced functional deficits. Translational Relevance: Results from this study may allow clinicians to improve screening accuracy for HCQ toxicity by using the alternative modality of MP. SN - 2164-2591 UR - https://www.unboundmedicine.com/medline/citation/31602344/Comparison_of_Fundus-Guided_Microperimetry_and_Multifocal_Electroretinography_for_Evaluating_Hydroxychloroquine_Maculopathy L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31602344/ DB - PRIME DP - Unbound Medicine ER -