Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients

Objectives The current study was conducted to compare between the conventional eye examination methods named as visual acuity, fundus examination, and field of vision evaluation in one hand and electrophysiologic methods of eye examination as visual evoked potential eye study in the other hand in de...

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Main Authors: Abeer H Ismaiel, Amal Arafa Mohsen, Assem Anwar
Format: Article
Language:English
Published: General Organization of Teaching Hospitals and Institutes 2020-01-01
Series:Journal of Medicine in Scientific Research
Subjects:
Online Access:http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=161;epage=167;aulast=Ismaiel
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author Abeer H Ismaiel
Amal Arafa Mohsen
Assem Anwar
author_facet Abeer H Ismaiel
Amal Arafa Mohsen
Assem Anwar
author_sort Abeer H Ismaiel
collection DOAJ
description Objectives The current study was conducted to compare between the conventional eye examination methods named as visual acuity, fundus examination, and field of vision evaluation in one hand and electrophysiologic methods of eye examination as visual evoked potential eye study in the other hand in detecting antimalarial medications toxicity on the eye macula in rheumatic patients. Materials and methods Fifty rheumatic patients group and fifty healthy control group age and sex matched were studied. Patients receiving anti-malarial medications for more than 6 months with cumulative dosage of at least 200 grams were included. All patients and control were subjected to full history and ocular examinations including visual acuity testing, fundus examination, visual field examination, and electrophysiological examinations (visual evoked potential) VEP. Results There was a statistical significant difference between percentage of patients and control group who having abnormal field of vision with P< 0.01, however there was no statistical significant difference between percentage of patients having abnormal visual acuity and control group with (P=0.06). There were statistical significant difference between percentage of patients and control group who having delayed P100 latency, low amplitude of P100 wave, abnormal (IOD) of P100 latency and amplitude with (P < 0.001). P100 latency was superior in sensitivity and specificity (57% & 98%) not only on field of vision but also superior on other VEP parameters, and both P100 latency and amplitude increased the sensitivity of VEP test to 62% and specificity to 100%. P100 latency of VEP is significantly correlated with duration of treatment with antimalarial drugs (r= 0.529 - P < 0.001 & r=0.285 - P=0.04). However, there is no significant correlation between duration of treatment and other VEP parameters. Conclusion We conclude that P100 latency of VEP can be useful parameter to detect CQ/HCQ retinal toxicity as it was superior in sensitivity and specificity and is significantly correlated to duration of treatment with antimalarial drugs, however, both field of vision examination and P100 amplitude parameters are inferior to P 100 latency in detecting macular changes.
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spelling doaj.art-803e765bb178430bb6e8c9400c1d17e32024-04-02T15:39:16ZengGeneral Organization of Teaching Hospitals and InstitutesJournal of Medicine in Scientific Research2537-091X2537-09282020-01-013316116710.4103/JMISR.JMISR_29_20Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patientsAbeer H IsmaielAmal Arafa MohsenAssem AnwarObjectives The current study was conducted to compare between the conventional eye examination methods named as visual acuity, fundus examination, and field of vision evaluation in one hand and electrophysiologic methods of eye examination as visual evoked potential eye study in the other hand in detecting antimalarial medications toxicity on the eye macula in rheumatic patients. Materials and methods Fifty rheumatic patients group and fifty healthy control group age and sex matched were studied. Patients receiving anti-malarial medications for more than 6 months with cumulative dosage of at least 200 grams were included. All patients and control were subjected to full history and ocular examinations including visual acuity testing, fundus examination, visual field examination, and electrophysiological examinations (visual evoked potential) VEP. Results There was a statistical significant difference between percentage of patients and control group who having abnormal field of vision with P< 0.01, however there was no statistical significant difference between percentage of patients having abnormal visual acuity and control group with (P=0.06). There were statistical significant difference between percentage of patients and control group who having delayed P100 latency, low amplitude of P100 wave, abnormal (IOD) of P100 latency and amplitude with (P < 0.001). P100 latency was superior in sensitivity and specificity (57% & 98%) not only on field of vision but also superior on other VEP parameters, and both P100 latency and amplitude increased the sensitivity of VEP test to 62% and specificity to 100%. P100 latency of VEP is significantly correlated with duration of treatment with antimalarial drugs (r= 0.529 - P < 0.001 & r=0.285 - P=0.04). However, there is no significant correlation between duration of treatment and other VEP parameters. Conclusion We conclude that P100 latency of VEP can be useful parameter to detect CQ/HCQ retinal toxicity as it was superior in sensitivity and specificity and is significantly correlated to duration of treatment with antimalarial drugs, however, both field of vision examination and P100 amplitude parameters are inferior to P 100 latency in detecting macular changes.http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=161;epage=167;aulast=Ismaielvisual evoked potentialfield of visionhydroxychloroquine and chloroquineretinal toxicity
spellingShingle Abeer H Ismaiel
Amal Arafa Mohsen
Assem Anwar
Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
Journal of Medicine in Scientific Research
visual evoked potential
field of vision
hydroxychloroquine and chloroquine
retinal toxicity
title Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
title_full Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
title_fullStr Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
title_full_unstemmed Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
title_short Comparative study between visual evoked potential and visual acuity, field of vision, and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
title_sort comparative study between visual evoked potential and visual acuity field of vision and fundus examination as screening tool for early diagnosis of hydroxychloroquine and chloroquine retinal toxicity in rheumatic patients
topic visual evoked potential
field of vision
hydroxychloroquine and chloroquine
retinal toxicity
url http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=161;epage=167;aulast=Ismaiel
work_keys_str_mv AT abeerhismaiel comparativestudybetweenvisualevokedpotentialandvisualacuityfieldofvisionandfundusexaminationasscreeningtoolforearlydiagnosisofhydroxychloroquineandchloroquineretinaltoxicityinrheumaticpatients
AT amalarafamohsen comparativestudybetweenvisualevokedpotentialandvisualacuityfieldofvisionandfundusexaminationasscreeningtoolforearlydiagnosisofhydroxychloroquineandchloroquineretinaltoxicityinrheumaticpatients
AT assemanwar comparativestudybetweenvisualevokedpotentialandvisualacuityfieldofvisionandfundusexaminationasscreeningtoolforearlydiagnosisofhydroxychloroquineandchloroquineretinaltoxicityinrheumaticpatients