Department of Ophthalmology, Asan Medical Center, Ulsan University School of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Sci Rep. 2022 Aug 30;12(1):14778. doi: 10.1038/s41598-022-19048-0.
In this study, we investigated the patterns of visual field (VF) defects and the diagnostic abilities of VF tests using different strategies in Asian patients with hydroxychloroquine retinopathy. Patients screened for hydroxychloroquine retinopathy using optical coherence tomography, fundus autofluorescence, VF, and/or multifocal electroretinography were included. The VF was performed using the Humphrey 30-2 and/or 10-2 strategy, and 2,107 eyes of 1,078 patients with reliable results, including 136 eyes of 68 patients with hydroxychloroquine retinopathy, were analyzed. The characteristics of VF findings were evaluated and the sensitivity and specificity were compared between the 30-2 and 10-2 tests in subgroups of retinopathy severity and pattern. The most common VF defect pattern was partial- or full-ring scotoma in both the 10-2 and 30-2 tests. Among the eyes with hydroxychloroquine retinopathy that underwent both tests, 14.2% showed a disparity between the two tests, almost all at the early stage. In overall and early pericentral retinopathy, the sensitivity of the 30-2 test was significantly higher than that of the 10-2 test (95.7% vs. 77.1% and 90.6% vs. 53.1%, respectively; P < 0.05). However, the specificity of the 10-2 test was significantly higher than that of the 30-2 test (89.6% vs. 84.8%, P < 0.001). Therefore, the pattern of retinopathy should be carefully considered when choosing a VF strategy for better detection of hydroxychloroquine retinopathy.
在这项研究中，我们调查了使用不同策略的视野（VF）缺陷模式和 VF 测试在亚洲羟氯喹性视网膜病变患者中的诊断能力。纳入了使用光学相干断层扫描、眼底自发荧光、VF 和/或多焦视网膜电图筛查羟氯喹性视网膜病变的患者。使用 Humphrey 30-2 和/或 10-2 策略进行 VF 检查，分析了包括 68 例羟氯喹性视网膜病变患者的 136 只眼在内的 1078 例患者的 2107 只眼可靠结果。评估了 VF 检查结果的特征，并比较了 30-2 和 10-2 检查在视网膜病变严重程度和模式亚组中的敏感性和特异性。在 10-2 和 30-2 检查中，最常见的 VF 缺陷模式是部分或全环暗点。在接受了两种检查的羟氯喹性视网膜病变眼中，有 14.2%的眼两种检查结果不一致，几乎都处于早期阶段。在整体和早期中心旁视网膜病变中，30-2 检查的敏感性明显高于 10-2 检查（95.7%比 77.1%和 90.6%比 53.1%；P<0.05）。然而，10-2 检查的特异性明显高于 30-2 检查（89.6%比 84.8%，P<0.001）。因此，在选择 VF 策略时，应仔细考虑视网膜病变的模式，以便更好地检测羟氯喹性视网膜病变。
