June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Correlated Changes in Retinal Thickness and Visuomotor Function in Asymptomatic Hydroxychloroquine Toxicity Patients
Author Affiliations & Notes
  • Loh-Shan Bryan Leung
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Bryce Hwang
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Andrew Raphael Berneshawi
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Rahul Goel
    NASA Ames Research Center, Moffett Field, California, United States
    San Jose State University, San Jose, California, United States
  • Terence Tyson
    NASA Ames Research Center, Moffett Field, California, United States
  • Robert T. Chang
    Ophthalmology, Stanford University School of Medicine, Stanford, California, United States
  • Leland S Stone
    NASA Ames Research Center, Moffett Field, California, United States
  • Footnotes
    Commercial Relationships   Loh-Shan Leung None; Bryce Hwang None; Andrew Berneshawi None; Rahul Goel None; Terence Tyson None; Robert Chang None; Leland Stone U.S. Patent No. 9,730,582, Code P (Patent)
  • Footnotes
    Support  NASA Human Research Program; unrestricted grant from Research to Prevent Blindness; National Eye Institute (P30-EY026877)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3789 – F0210. doi:
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    • Get Citation

      Loh-Shan Bryan Leung, Bryce Hwang, Andrew Raphael Berneshawi, Rahul Goel, Terence Tyson, Robert T. Chang, Leland S Stone; Correlated Changes in Retinal Thickness and Visuomotor Function in Asymptomatic Hydroxychloroquine Toxicity Patients. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3789 – F0210.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We have previously shown that a 5-min eye-movement test can capture many largely independent “oculometric” parameters of human visual/visuomotor function (Liston & Stone, 2014). This test has been successfully used to characterize mild neural impairment due to traumatic brain injury, sleep and circadian disruption, and alcohol consumption (Liston et al., 2017; Stone et al, 2019; Tyson et al, 2021). Here, we extend this approach to study patients at risk of progressive posterior-segment illness to see how oculometrics relate to standard clinical ophthalmological measures.

Methods : Five female patients (≥20/40 BCVA, 34-60 years old) undergoing hydroxychloroquine treatment (2-7mg/kg/day for 10-23 years for rheumatologic illness) have participated thus far. Under monocular viewing conditions in randomized order, they tracked a moving spot undergoing radial step-ramp motion in 90 randomized directions, at 5 randomized speeds, starting at random times (see Stone et al, 2019). We computed nine independent oculometrics (latency, initial acceleration, steady-state gain, proportion smooth, saccadic rate, saccadic amplitude, direction noise, speed responsiveness, and speed noise). Spectral-domain optical coherence tomography (Zeiss, Dublin, CA) was used to measure the average thickness of the nine Early Treatment Diabetic Retinopathy Study macular sectors from the internal limiting membrane to the retinal pigmented epithelium. We used Pearson’s correlation between retinal thickness and our oculometrics with t-statistics to test separate one-sided hypotheses across 10 retinae.

Results : We found significant changes in different aspects of visuomotor performance. Most notably, latency increased, initial acceleration decreased, and steady-state pursuit gain decreased as retinal thickness decreased (r2 = 0.364, 0.579, & 0.692; one-tailed P = 0.032, 0.005, & 0.001, respectively). Speed responsiveness appeared to decrease although marginally for our current sample (r2 = 0.253, P = 0.069). Lastly, direction discrimination and saccadic behavior appeared unchanged.

Conclusions : Oculometrics may provide sensitive measures of changes in retinal thickness. More importantly, they have the potential to detect impairment before it becomes evident with standard clinical imaging, while also providing insight into the behavioral implications of any resulting deficits in visual/visuomotor function.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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