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N. Barzideh, B.M. Glaser, V. Djafari; Microperimetry Is an Effective Test for Diagnosing Early Scotomas Secondary to Hydroxychloroquine Maculopathy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3811.
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It is known that hydroxychloroquine can cause maculopathy and interfere with central visual function. This study describes using Microperimeter visual field testing (NIDEK Technologies) as a sensitive diagnostic tool for recognizing macular toxicity secondary to hydroxychloroquine. This study proposes that microperimetery can diagnose hydroxychloroquine maculopathy sooner than color photos and dilated fundus examinations.
A retrospective case study was performed on patients with hydroxycholoroquine maculopathy including visual acuity testing, dilated fundus exam, color photography, and microperimetery on each patient.
Three patients complaining of blurred vision while taking hydroxychloroquine were evaluated. Despite normal visual acuity and lack of pigmentary changes on fundus exam and color photos, microperimetery performed on the central 10 degrees showed moderately decreased sensitivity (6–8 dB, Normal 20 dB) and scotoma in the parafoveal region in all three patients.
Microperimeter visual field test of the macula is a useful tool for diagnosing and tracking hydroxychloroquine maculopathy. Currently, diagnosis of this condition is accomplished by observing pigmentary changes on dilated fundus exam, or based on the presence of defects on Humphrey visual field testing of the central 10 degrees of vision. This case series demonstrates that microperimetery is valuable for diagnosing hydroxychloroquine related toxicity because it measures the sensitivity of individual points in the macula. In our case series, macular sensitivity was decreased on microperimeter testing despite the absence of pigmentary changes in the macula, normal visual acuity and normal color photo examinations in these three patients. This case series suggests that microperimeter may be a valuable tool for the early detection of macular toxicity secondary to hydroxychloroquine.
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