Ophthalmology Department, Nuestra Señora de la Candelaria University Hospital, Spain.
Rom J Ophthalmol. 2021 Jul-Sep;65(3):235-240. doi: 10.22336/rjo.2021.47.
The aim was to evaluate the value of microperimetry (MP) in the early detection of toxic maculopathy caused by HCQ treatment in patients with normal fundoscopy, as well as normal structural optical coherence tomography (OCT). Microperimetry was performed in 13 patients under hydroxychloroquine treatment, who did not present fundoscopic or structural OCT alterations compatible with maculopathy. We used Nidek MP3s equipment (Nidek, Gamagori, Japan) with a 13-point pattern centered in fovea, in mesopic mode and in scotopic mode. The mean retinal sensitivity (MRS) in the study group was 27.25 +/ - 2.80 dB (95% CI 26.09 to 28.41 dB) while in the group of healthy volunteers 29.34 +/ - 2.18 dB (95% CI 28.67 to 30.1 dB). In scotopic mode, the mean sensitivity was 13.38 +/ - 1.43 dB (95% CI 12.79 to 13.97 dB) for HCQ users and 14.40 +/ - 2.1 dB (95% CI 13.76 to 15.04 dB) in the non-user group. Central retinal sensitivity (CRS) was also lower in patients using HCQ 26.52 +/ -4.0 dB (95% CI 24.8 to 28.15 dB) vs. 29.06 +/ - 2.5 dB (95% CI 28.33 to 29.87 dB) in the control group in mesopic mode. The trend was repeated in scotopic CRS (10.85 +/ -1.84 dB vs. 12.16 +/ - 2.61 dB respectively). Our results showed that MP, especially in its mesopic mode, is a useful method to detect retinal toxicity caused by HCQ consumption in patients without funduscopic alteration and with normal macular OCT. In mesopic mode, MRS was significantly lower in patients with long-term hydroxychloroquine treatment compared to those who did not use it, even in cases in which no fundoscopic or structural OCT alteration was detected. HCQ = hydroxychloroquine, MP = microperimetry, OCT = optical coherence tomography, BCVA = best corrected visual acuity, CRS = central retinal sensitivity, RS = retinal sensitivity, GEE = generalized estimating equations, MRS = mean retinal sensitivity, MfERG = multifocal electroretinogram, AMD = age-related macular degeneration.
目的是评估微视野计（MP）在检测接受羟氯喹（HCQ）治疗的患者中，眼底镜和结构光学相干断层扫描（OCT）均正常但存在中毒性黄斑病变时的价值。对 13 名接受 HCQ 治疗但眼底镜和结构 OCT 检查均未发现与黄斑病变相符的改变的患者进行微视野计检查。我们使用 Nidek MP3s 设备（日本群马县的尼德克公司），以黄斑中心凹为中心进行 13 点检测，在明适应和暗适应模式下进行。研究组的平均视网膜敏感度（MRS）为 27.25 +/ - 2.80 dB（95%置信区间为 26.09 至 28.41 dB），而健康志愿者组为 29.34 +/ - 2.18 dB（95%置信区间为 28.67 至 30.1 dB）。在暗适应模式下，HCQ 使用者的平均敏感度为 13.38 +/ - 1.43 dB（95%置信区间为 12.79 至 13.97 dB），而非使用者组为 14.40 +/ - 2.1 dB（95%置信区间为 13.76 至 15.04 dB）。明适应模式下，HCQ 使用者的中央视网膜敏感度（CRS）也较低，为 26.52 +/ -4.0 dB（95%置信区间为 24.8 至 28.15 dB），而对照组为 29.06 +/ - 2.5 dB（95%置信区间为 28.33 至 29.87 dB）。在暗适应 CRS 中也观察到类似的趋势（分别为 10.85 +/ -1.84 dB 和 12.16 +/ - 2.61 dB）。我们的结果表明，MP 特别是在明适应模式下，是一种有用的方法，可以检测到眼底镜和 OCT 检查均正常但存在黄斑毒性的 HCQ 使用者。在明适应模式下，与未使用者相比，长期接受羟氯喹治疗的患者的 MRS 明显更低，即使在未发现眼底镜或结构 OCT 改变的情况下也是如此。HCQ = 羟氯喹，MP = 微视野计，OCT = 光学相干断层扫描，BCVA = 最佳矫正视力，CRS = 中央视网膜敏感度，RS = 视网膜敏感度，GEE = 广义估计方程，MRS = 平均视网膜敏感度，MfERG = 多焦视网膜电图，AMD = 年龄相关性黄斑变性。
