June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Comparing functional defects measured by mfERG and standard automated perimetry in patients under (hydroxy-)chloroquine therapy
Author Affiliations & Notes
  • Cord R H Huchzermeyer
    Ophthalmology, Universitatsklinikum Erlangen, Erlangen, Bayern, Germany
  • Jan J Kremers
    Ophthalmology, Universitatsklinikum Erlangen, Erlangen, Bayern, Germany
  • Footnotes
    Commercial Relationships   Cord Huchzermeyer None; Jan Kremers None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3782 – F0203. doi:
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      Cord R H Huchzermeyer, Jan J Kremers; Comparing functional defects measured by mfERG and standard automated perimetry in patients under (hydroxy-)chloroquine therapy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3782 – F0203.

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

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Abstract

Purpose : We characterized the relationship between multifocal electroretinograms (mfERG) and standard automated perimetry (SAP) in patients receiving therapy with (hydroxy-)chloroquine.

Methods : In this retrospecitve observational study, data from patients who were screened for toxic maculopathy in our outpatient clinic were included. Perimetry was performed with the Octopus 900 perimeter (Haag-Streit, Switzerland) using the M-pattern (81 locations in the central 10°) and a full-threshold algorithm. MfERGs were measured in 61 hexagons in the central 30° of the visual field with the RetiPortSystem (RolandConsult). MfERGs with an amplitude ratio between rings 2 and 5 smaller or equal to 2 were defined as having Bull’s-Eye-Maculopathy (BEM).

Results : The right eyes of 49 patients (age at baseline: 52.7 ± 13.4 yrs, 40 female, 35 hydroxychloroquine) were included. Follow-up was between 0.5 and 8.0 years. Clinically, no patient showed clear progression or developed new BEM during follow-up. Therefore, we averaged measurements over several visits for this first analysis. The spatial distribution of functional losses in mfERG and SAP in patients with BEM (n = 9) is shown in Figure 1.
Both mfERGs and visual fields demonstrate that locations/segments that correspond to the second ring were not equally affected - in our patients, regions inferior to the foveola retained better function. Patients with definite BEM in the ERG also had visual field defects. In a first exploratory analysis, a quadratic linear model seemed adequate to describe the relationship between mfERG amplitude and perimetric defect (see inset of Figure 1, p < 0.001).

Conclusions : Improved screening for functional consequences of toxic maculapathy might be achieved by techniques that 1) analyze individual loci instead of rings (possibly using artificial intelligence) and 2) combine mfERG and perimetry measurements.

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

 

The differences in perimetric defect and in log mfERG-amplitude between patients with (n = 9) or without (n = 40) manifest BEM. Perimetric test locations are shown as black dots with surrounding rings, superimposed on the hexagonal grid of the mfERG. Darker colors and larger rings indicate higher loss. The inset shows the relationship between mfERG amplitudes in segment 32 (red) and the perimetric defects averaged over the six locations that clearly correspond to this segment.

The differences in perimetric defect and in log mfERG-amplitude between patients with (n = 9) or without (n = 40) manifest BEM. Perimetric test locations are shown as black dots with surrounding rings, superimposed on the hexagonal grid of the mfERG. Darker colors and larger rings indicate higher loss. The inset shows the relationship between mfERG amplitudes in segment 32 (red) and the perimetric defects averaged over the six locations that clearly correspond to this segment.

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