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Published in: Documenta Ophthalmologica 3/2015

01-06-2015 | Original Research Article

Influence of chloroquine intake on the multifocal electroretinogram in patients with and without maculopathy

Authors: Richard Bergholz, Klaus Rüther, Jan Schroeter, Christoph von Sonnleithner, Daniel J. Salchow

Published in: Documenta Ophthalmologica | Issue 3/2015

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Abstract

Purpose

To evaluate the effect of long-term chloroquine intake on the multifocal electroretinogram (mfERG) in female patients with and without maculopathy.

Methods

Retrospective analysis of the mfERGs recorded in three different groups: (1) patients with bilateral maculopathy having taken chloroquine, (2) patients without maculopathy having taken chloroquine, and (3) healthy control subjects (age-matched to group 2) who never took chloroquine. MfERGs of each group were averaged, and the data of each patient group were compared to the control group. The main outcome measures were N1 and P1 characteristics and the ring ratio analysis.

Results

In group 1, 11 female subjects (22 eyes) were included, group 2 consisted of nine patients (18 eyes) and group 3 of seven healthy female subjects (14 eyes). Compared with healthy controls, patients in group 1 showed significantly reduced response densities of both N1 and P1 across all ring eccentricities except ring 5. Implicit times were significantly delayed only concerning N1 (ring 4 and the sum response of the left eye of group 1). P1 implicit times showed no significant alterations in either group. Ring ratios of the response densities were significantly higher mainly concerning group 1 (N1: ring 5/ring 2 and ring 5/ring 4 of the right eye; P1: all ring ratios of the right eye and all ratios except ring 5/ring 1 and ring 5/ring 4 of the left eye). The only ring ratio being significantly higher in group 2 was P1 ring 5/ring 1 ratio of the right eye.

Conclusions

In the absence of clinically apparent maculopathy, chloroquine intake was not associated with major alterations of the mfERG.
Literature
1.
go back to reference Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF (2011) Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology 118:415–422CrossRefPubMed Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF (2011) Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology 118:415–422CrossRefPubMed
2.
go back to reference Pluta JP, Ruther K (2009) Retinal damage by (hydroxy)chloroquine intake: published evidence for an efficient ophthalmological follow-up. Klin Monbl Augenheilkd 226:891–896CrossRefPubMed Pluta JP, Ruther K (2009) Retinal damage by (hydroxy)chloroquine intake: published evidence for an efficient ophthalmological follow-up. Klin Monbl Augenheilkd 226:891–896CrossRefPubMed
3.
go back to reference Lai TY, Chan WM, Li H, Lai RY, Lam DS (2005) Multifocal electroretinographic changes in patients receiving hydroxychloroquine therapy. Am J Ophthalmol 140:794–807CrossRefPubMed Lai TY, Chan WM, Li H, Lai RY, Lam DS (2005) Multifocal electroretinographic changes in patients receiving hydroxychloroquine therapy. Am J Ophthalmol 140:794–807CrossRefPubMed
4.
go back to reference Maturi RK, Yu M, Weleber RG (2004) Multifocal electroretinographic evaluation of long-term hydroxychloroquine users. Arch Ophthalmol 122:973–981CrossRefPubMed Maturi RK, Yu M, Weleber RG (2004) Multifocal electroretinographic evaluation of long-term hydroxychloroquine users. Arch Ophthalmol 122:973–981CrossRefPubMed
5.
go back to reference Marmor MF (2005) The dilemma of hydroxychloroquine screening: new information from the multifocal ERG. Am J Ophthalmol 140:894–895CrossRefPubMed Marmor MF (2005) The dilemma of hydroxychloroquine screening: new information from the multifocal ERG. Am J Ophthalmol 140:894–895CrossRefPubMed
6.
go back to reference Hood DC, Bach M, Brigell M, Keating D, Kondo M, Lyons JS et al (2012) ISCEV standard for clinical multifocal electroretinography (mfERG) (2011 edition). Doc Ophthalmol 124:1–13CrossRefPubMed Hood DC, Bach M, Brigell M, Keating D, Kondo M, Lyons JS et al (2012) ISCEV standard for clinical multifocal electroretinography (mfERG) (2011 edition). Doc Ophthalmol 124:1–13CrossRefPubMed
7.
go back to reference Adam MK, Covert DJ, Stepien KE, Han DP (2012) Quantitative assessment of the 103-hexagon multifocal electroretinogram in detection of hydroxychloroquine retinal toxicity. Br J Ophthalmol 96:723–729CrossRefPubMed Adam MK, Covert DJ, Stepien KE, Han DP (2012) Quantitative assessment of the 103-hexagon multifocal electroretinogram in detection of hydroxychloroquine retinal toxicity. Br J Ophthalmol 96:723–729CrossRefPubMed
8.
go back to reference Lyons JS, Severns ML (2009) Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity: a review: review of mfERG ring ratios in Plaquenil toxicity. Doc Ophthalmol 118:29–36CrossRefPubMed Lyons JS, Severns ML (2009) Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity: a review: review of mfERG ring ratios in Plaquenil toxicity. Doc Ophthalmol 118:29–36CrossRefPubMed
9.
go back to reference Bergholz R, Schroeter J, Ruther K (2010) Evaluation of risk factors for retinal damage due to chloroquine and hydroxychloroquine. Br J Ophthalmol 94:1637–1642CrossRefPubMed Bergholz R, Schroeter J, Ruther K (2010) Evaluation of risk factors for retinal damage due to chloroquine and hydroxychloroquine. Br J Ophthalmol 94:1637–1642CrossRefPubMed
10.
go back to reference Ruther K, Foerster J, Berndt S, Schroeter J (2007) Chloroquine/hydroxychloroquine: variability of retinotoxic cumulative doses. Ophthalmologe 104:875–879CrossRefPubMed Ruther K, Foerster J, Berndt S, Schroeter J (2007) Chloroquine/hydroxychloroquine: variability of retinotoxic cumulative doses. Ophthalmologe 104:875–879CrossRefPubMed
Metadata
Title
Influence of chloroquine intake on the multifocal electroretinogram in patients with and without maculopathy
Authors
Richard Bergholz
Klaus Rüther
Jan Schroeter
Christoph von Sonnleithner
Daniel J. Salchow
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Documenta Ophthalmologica / Issue 3/2015
Print ISSN: 0012-4486
Electronic ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-015-9486-x

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