Early hydroxychloroquine retinopathy: optical coherence tomography abnormalities preceding Humphrey visual field defects

2019 ◽  
Vol 103 (11) ◽  
pp. 1600-1604 ◽  
Author(s):  
Sean T Garrity ◽  
Joo Yeon Jung ◽  
Olivia Zambrowski ◽  
Francesco Pichi ◽  
Daniel Su ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Vision Loss ◽  
Tertiary Care ◽  
Fundus Photography ◽  
Visual Field Defects ◽  
Optical Coherence ◽  
Humphrey Visual Field ◽  
Hydroxychloroquine Retinopathy ◽  
Field Defects

Background/AimsHydroxychloroquine (HCQ) retinopathy may result in severe and irreversible vision loss, emphasising the importance of screening and early detection. The purpose of this study is to report the novel finding of early optical coherence tomography (OCT) abnormalities due to HCQ toxicity that may develop in the setting of normal Humphrey visual field (HVF) testing.MethodsData from patients with chronic HCQ exposure was obtained from seven tertiary care retina centres. Ten patients with HCQ-associated OCT abnormalities and normal HVF testing were identified. Detailed analysis of the OCT findings and ancillary tests including colour fundus photography, fundus autofluorescence, multifocal electroretinography and microperimetry was performed in these patients.ResultsSeventeen eyes from 10 patients illustrated abnormalities with OCT and normal HVF testing. These OCT alterations included (1) attenuation of the parafoveal ellipsoid zone and (2) loss of a clear continuous interdigitation zone. Several eyes progressed to advanced parafoveal outer retinal disruption and/or paracentral visual field defects.ConclusionPatients with high risk HCQ exposure and normal HVF testing may develop subtle but characteristic OCT abnormalities. This novel finding indicates that, in some cases of early HCQ toxicity, structural alterations may precede functional impairment. It is therefore important to employ a screening approach that includes OCT to assess for these early findings. Ancillary testing should be considered in cases with suspicious OCT changes and normal HVFs.

scholarly journals Consistency between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes

2020 ◽  
Author(s):  
Wen Wen ◽  
Yuqiu Zhang ◽  
Ting Zhang ◽  
Xinghuai Sun
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
High Myopia ◽  
Open Angle Glaucoma ◽  
Visual Field Defects ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Cross Classification ◽  
Field Defects ◽  
Good Agreement

Abstract Background. The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG). Methods. We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics. Results. In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and 10-2 MS (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P < 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289). Conclusions. In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.

scholarly journals Consistency Between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes

2020 ◽  
Author(s):  
Wen Wen ◽  
Yuqiu Zhang ◽  
Ting Zhang ◽  
Xinghuai Sun
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
High Myopia ◽  
Open Angle Glaucoma ◽  
Visual Field Defects ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Cross Classification ◽  
Field Defects ◽  
Good Agreement

Abstract Background:The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG).Methods:We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics. Results: In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and 10-2 MS (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P< 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289).Conclusions: In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.

scholarly journals Estimating Lead Time Gained by Optical Coherence Tomography in Detecting Glaucoma before Development of Visual Field Defects

Ophthalmology ◽  
2015 ◽  
Vol 122 (10) ◽  
pp. 2002-2009 ◽  
Author(s):  
Tammy M. Kuang ◽  
Chunwei Zhang ◽  
Linda M. Zangwill ◽  
Robert N. Weinreb ◽  
Felipe A. Medeiros
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Lead Time ◽  
Visual Field Defects ◽  
Optical Coherence ◽  
Field Defects

scholarly journals Consistency between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes

2020 ◽  
Author(s):  
Wen Wen ◽  
Yuqiu Zhang ◽  
Ting Zhang ◽  
Xinghuai Sun
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
High Myopia ◽  
Open Angle Glaucoma ◽  
Visual Field Defects ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Cross Classification ◽  
Field Defects ◽  
Good Agreement

Abstract Background: The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG). Methods: We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics. Results: In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and 10-2 MS (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P < 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289). Conclusions: In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.

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