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Article Type

Original Study

Abstract

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.

Keywords

visual evoked potential, field of vision, hydroxychloroquine and chloroquine, retinal toxicity

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