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Comparison of different screening methods for chloroquine/hydroxychloroquine retinopathy: multifocal electroretinography, color vision, perimetry, ophthalmoscopy, and fluorescein angiography

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare various screening methods for the early diagnosis of retinal dysfunction in patients with long-term chloroquine (CQ) and hydroxychloroquine (HCQ) treatment.

Methods

Twenty patients with long-term CQ/HCQ treatment underwent ophthalmologic evaluation including visual acuity testing, ophthalmoscopy, fluorescein angiography, color vision tests, visual field and multifocal electroretinography (mfERG).

Results

In 14 patients, retinal dysfunction was indicated in the mfERG (reduced amplitudes and/or delayed implicit times) in the parafoveal area. Towards the periphery, the function was normal or only moderately reduced. Ophthalmoscopy and fluorescein angiography identified pathologic retinal changes in seven of these 14 patients. Six patients had normal mfERG, ophthalmoscopy, and fluorescein angiography. Results of color vision and visual field testing were variable even in patients with morphologic alterations.

Conclusion

The use of mfERG may detect retinal dysfunction in a considerable number of eyes with normal ophthalmocopy and fluorescein angiography. The higher variability of color vision and visual field testing results suggests the use of mfERG as primary screening tool for retinal dysfunction in long-term CQ/HCQ treatment.

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Authors and Affiliations

  1. Department of Ophthalmology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Susann Mißner & Ulrich Kellner

  2. AugenZentrum Siegburg, Europaplatz 3, 53721, Siegburg, Germany

    Ulrich Kellner

  3. RetinaScience, Postfach 301212, 53192, Bonn, Germany

    Ulrich Kellner

Authors
  1. Susann Mißner
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  2. Ulrich Kellner
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Correspondence to Susann Mißner.

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Mißner, S., Kellner, U. Comparison of different screening methods for chloroquine/hydroxychloroquine retinopathy: multifocal electroretinography, color vision, perimetry, ophthalmoscopy, and fluorescein angiography. Graefes Arch Clin Exp Ophthalmol 250, 319–325 (2012). https://doi.org/10.1007/s00417-011-1753-2

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  • DOI: https://doi.org/10.1007/s00417-011-1753-2

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