Comparison of Visual Evoked Potential and Electro-oculogram Tests in Early Detection of Hydroxychloroquine Retinal Toxicity
Journal of Ophthalmic and Optometric Sciences,
Vol. 1 No. 1 (2016),
6 October 2016
,
Page 19-26
https://doi.org/10.22037/joos.v1i1.14315
Abstract
Purpose: To compare the sensitivity of visual evoked potential (VEP) and electro-oculogram (EOG) tests in early detection of hydroxychloroquine (HCQ) retinal toxicity.
Patients and Methods: In this prospective cross-sectional study, 100 consecutive patients (age range: 18 to 30) with juvenile rheumatoid arteritis (JRA) and a cumulative hydroxychloroquine dosage of at least 200gr were included. In addition 100 healthy individuals with matched age and sex were included as controls. Ocular examinations including visual acuity testing, refractive errors measurement, applanation tonometry, slit lamp biomicroscopy fundus ophthalmoscopy and electrophysiological examinations (EOG and VEP) were performed in both groups. Scores of less than 1.8 for the Arden Index in EOG (AI), as well as less than 4mv of P100 amplitude and more than 110ms of P100 latency in VEP were considered abnormal.
Results: The mean cumulative dosage of HCQ among participants was 262.4±31.9g (95% CI: 256.1 to 268.8g). The mean measurement of AI (EOG), P100 latency and amplitude of VEP were 1.8±0.4, 112.7±10.1ms and 3.7±2.1mv, respectively. There was a significant difference between case and control groups in all parameters (p<0.001 for all). There was not any significant difference between AI (EOG), P100 latency and amplitude of VEP in detecting the ocular toxicity due to HCQ.
Conclusion: We conclude that AI (EOG), P100 amplitude and latency of VEP can all be useful parameters to detect HCQ retinal toxicity, and we did not detect any difference between these two methods.
- Hydroxychloroquine
- visual evoked potential test
- electro-oculogram test
- retinal toxicity.
How to Cite
References
Anyanwu EC, Kanu I, Nnadozie JB. Electrophysiological evaluation of adolescents presenting with chloroquine toxicity due to persistent malaria infections. Internet J Neurol. 2006;5(2):283-9.
Yam JC, Kwok AK. Ocular toxicity of hydroxychloroquine. Hong Kong Med J. 2006;12(4):294-304.
Rynes RI. Antimalarial drugs in the treatment of rheumatological diseases. Br J Rheumatol. 1997;36(7):799-805.
Heravian J, Saghafi M, Shoeibi N, Hassanzadeh S, Shakeri MT, Sharepoor M. A comparative study of the usefulness of color vision, photostress recovery time, and visual evoked potential tests in early detection of ocular toxicity from hydroxychloroquine. Int Ophthalmol. 2011;31(4):283-9.
Cambiaggi A. Unusual ocular lesions in a case of systemic lupus erythematosus. AMA Arch Ophthalmol. 1957;57(3):451-3.
Hobbs HE, Sorsby A, Freedman A. Retinopathy following chloroquine therapy. Lancet. 1959;2(7101):478-80.
Chiowchanwisawakit P, Nilganuwong S, Srinonprasert V, Boonprasert R, Chandranipapongse W, Chatsiricharoenkul S, et al.. Prevalence and risk factors for chloroquine maculopathy and role of plasma chloroquine and desethylchloroquine concentrations in predicting chloroquine maculopathy. Int J Rheum Dis. 2013;16(1):47-55.
Easterbrook M. Ocular effects and safety of antimalarial agents. Am J Med. 1988;85(4A):23-9.
Bishara SA, Matamoros N. Evaluation of several tests in screening for chloroquine maculopathy. Eye (Lond). 1989;3 ( Pt 6):777-82.
Neubauer AS, Samari-Kermani K, Schaller U, Welge-Lübetaen U, Rudolph G, Berninger T. Detecting chloroquine retinopathy: electro-oculogram versus colour vision. Br J Ophthalmol. 2003;87(7):902-8.
Cruess AF, Schachat AP, Nicholl J, Augsburger JJ. Chloroquine retinopathy. Is fluorescein angiography necessary? Ophthalmology. 1985;92(8):1127-9.
Marmor MF, Carr RE, Easterbrook M, Farjo AA, Mieler WF; American Academy of Ophthalmology. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy: a report by the American Academy of Ophthalmology. 2002;109(7):1377-82.
Mazzuca SA, Yung R, Brandt KD, Yee RD, Katz BP. Current practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil) therapy. J Rheumatol. 1994;21(1):59-63.
Bartel PR, Roux P, Robinson E, Anderson IF, Brighton SW, van der Hoven HJ, et al.. Visual function and long-term chloroquine treatment. S Afr Med J.1994;84(1):32-4.
Easterbrook M. Detection and prevention of maculopathy associated with antimalarial agents. Int Ophthalmol Clin. 1999;39(2):49-57.
Browning DJ. Hydroxychloroquine and chloroquine retinopathy: screening for drug toxicity. Am J Ophthalmol. 2002;133(5):649-56.
Arden GB, Kelsey JH. Changes produced by light in the standing potential of the human eye. J Physiol. 1962;161(2):189-204.
Arden GB, Friedman A, Kolb H. Anticipation of chloroquine retinopathy. Lancet. 1962;1(7240):1164-5.
Gouras P, Gunkel RD. The EOG in chloroquine and other retinopathies. Arch Ophthalmol. 1963;70(5):629-39.
Guideline 9B: guidelines on visual evoked potentials. American Clinical Neurophysiology Society. Am J Electroneurodiagnostic Technol. 2006;46(3):254-74.
College of Ophthalmologists. Chloroquine, hydroxychloroquine and the eye. London: College of Ophthalmologists:1993.
Grierson DJ. Hydroxychloroquine and visual screening in a rheumatology outpatient clinic. Ann Rheum Dis. 1997;56(3):188-90.
- Abstract Viewed: 1018 times
- PDF Downloaded: 324 times