Unit on Clinical Investigation of Retinal Disease, Division of Epidemiology & Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.
Invest Ophthalmol Vis Sci. 2022 Jan 3;63(1):15. doi: 10.1167/iovs.63.1.15.
This study investigates the association between local retina structure and visual function in a cohort with long-term hydroxychloroquine (HCQ) use.
The study included 84 participants (54 participants without toxicity and 30 participants with toxicity) with history of chronic HCQ use (14.5 ± 7.4 years) who had testing with spectral-domain optical coherence tomography (SD-OCT) imaging and Humphrey 10-2 visual fields. Optical coherence tomography (OCT) metrics (total and outer retina thickness [TRT and ORT], minimum intensity [MinI], and ellipsoid zone [EZ] loss) were sampled in regions corresponding to visual field test locations. Univariate linear correlations were investigated and a multivariate random forest regression using a combination of OCT metrics was used to predict visual field sensitivity by locus using a leave-one-out cross-validation strategy.
In univariate linear regression, EZ loss demonstrated the strongest relationship with visual field sensitivities in the parafoveal ring with R2 = 0.58. TRT and ORT revealed positive correlations with visual field sensitivity (R2 = 0.57 and 0.40, respectively), whereas total and outer retinal MinI yielded negative correlations (R2 = 0.10 and 0.22). The multivariate model improved correlations (R2 = 0.66) yielding a root mean squared error of 3.8 decibel (dB). Feature importance analysis identified EZ loss as the most relevant predictor of function.
Multiple OCT-derived quantitative metrics used in combination can provide information to predict local sensitivities. The results indicate a strong relationship between retinal function and OCT measures, which contribute to the understanding of the retinal toxicity caused by HCQ as well as being applicable to outcome development for other degenerative diseases of the outer retina.
本研究旨在调查长期使用羟氯喹（HCQ）的患者中局部视网膜结构与视觉功能之间的关联。
本研究纳入了 84 名有慢性 HCQ 使用史（14.5±7.4 年）的参与者（54 名无毒性和 30 名毒性），他们接受了光谱域光学相干断层扫描（SD-OCT）成像和 Humphrey 10-2 视野检查。在与视野测试位置相对应的区域中，对光学相干断层扫描（OCT）指标（全层和外层视网膜厚度[TRT 和 ORT]、最小强度[MinI]和椭圆体带[EZ]丢失）进行采样。研究采用单变量线性相关性分析，并使用 OCT 指标的组合进行多变量随机森林回归，通过留一交叉验证策略，使用 locus 预测视野敏感度。
在单变量线性回归中，EZ 丢失与旁中心凹环的视野敏感度相关性最强，R2=0.58。TRT 和 ORT 与视野敏感度呈正相关（R2=0.57 和 0.40），而全层和外层视网膜 MinI 呈负相关（R2=0.10 和 0.22）。多元模型提高了相关性（R2=0.66），均方根误差为 3.8 分贝（dB）。特征重要性分析确定 EZ 丢失是功能的最相关预测因子。
多种 OCT 衍生的定量指标结合使用可提供预测局部敏感度的信息。结果表明，视网膜功能与 OCT 测量之间存在很强的关系，这有助于了解 HCQ 引起的视网膜毒性，以及适用于其他外视网膜退行性疾病的结果发展。
