Abstract
Purpose: :
Hydroxychloroquine and chloroquine have been used to treat connective tissue diseases for many years. Rheumatologists have used these drugs due to their relatively low amount of systemic toxicity, however, these drugs can cause significant damage to ocular structures, specifically the retina. Early detection of toxicity and discontinuation of the drugs may arrest and potentially reverse the retinal side effects of these medications.
Methods: :
The MP–1 Microperimeter (Nidek) is used for fundus photography and field testing with specific retinal correlation. All patients taking hydroxychloroquine and chloroquine who were seen in a large ophthalmic practice and an affiliated university clinic were screened with an MP–1 microperimeter using standard macular settings. Patients were screened at baseline and at 1 year intervals. If microperimetry abnormalities were seen, the recommendation to discontinue the drug was made and testing was repeated 3 months later to determine if these findings were reversible.
Results: :
Over 50 patients have currently been screened. These patients have taken high risk medications for a time range of less than 1 month to over 5 years. 3 patients who had MP–1 microperimetry field defects were found to have reversal of these defects upon drug discontinuation.
Conclusions: :
MP–1 microperimetry is a highly useful adjunct in the ongoing evaluation of patients taking medications with a high risk of retinal toxicity. This microperimetry method has shown ability to detect toxicity at an early and potentially reversible state.
Keywords: drug toxicity/drug effects • retina • perimetry