The Diagnostic Utility of Multifocal Electroretinography in Detecting Chloroquine and Hydroxychloroquine Retinal Toxicity

Tsang, Adrian; Ahmadi, Sina; Hamilton, James B.; Gao, Jennifer; Virgili, Gianni; Coupland, Stuart G.; Gottlieb, Chloe

doi:10.1016/j.ajo.2019.04.025

Cited by 31 publications

(30 citation statements)

References 22 publications

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“…(15)The mfERG is more sensitive for diagnosis of HCQ-induced retinopathy in the early stages than the combination of AVF and SD-OCT tests. (25,29) For this reason, in this study, based on mfERG changes, we divided patients into two groups : patients with Abnormal mfERG (Case group) and patients with Normal mfERG (Control group) and evaluated them with OCTA imaging. Patients with RA and SLE were also evaluated in separate subgroups.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of optical coherence tomography angiography parameters in patients treated with hydroxychloroquine

Akhlaghi

Kianersi

Radmehr

et al. 2021

Preprint

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Background One of the major side effects of hydroxychloroquine is retinopathy. The aim of this study was to evaluate the Optical coherence tomography angiography (OCTA) parameters in a group of patients who have hydroxychloroquine-induced retinopathy based on Multifocal electroretinography (mfERG) with a group who do not have retinopathy.Method This is a Cross-Sectional Study. In this study, patients with RA or SLE who had been taking HCQ for at least 7 years were included. MfERG and OCTA imaging were performed for all patients. Patients were divided into Normal mfERG and Abnormal mfERG groups based on mfERG results. OCTA parameters were studied in these two groups.Result 61 patients (61 eyes) were included. 41 patients had SLE and 20 patients had RA. 40 patients (66.7%) had Abnormal mfERG. The mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). Mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). In RA subgroup, mean VD in SCP layer in PeriFovea region in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). Mean VD in DCP layer in Whole Image, Superior Hemi, Inferior Hemi, PeriFovea area in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). This discrepancy was also observed in the RA subgroup but not in the SLE subgroup. The mean of none of the parameters of FAZ (mm2), Flow Area of Outer Retina (mm2) and Flow Area of Choriocapillaris (mm2) were not statistically significant between the groups Abnormal mfERG and Normal mfERG. (p-value>0.05). Conclusion VD in the DCP layer decreased in abnormal mfERG patients compared to patients with normal mfERG. But it seems that VD in SCP layer, FAZ Area and Flow Area are similar in both groups. OCTA may be used as a non-invasive tool in the diagnosis of early stages of HCQ-induced retinopathy, especially in RA patients, but further studies are needed.

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Section: Discussionmentioning

confidence: 99%

Evaluation of optical coherence tomography angiography parameters in patients treated with hydroxychloroquine

Akhlaghi

Kianersi

Radmehr

et al. 2021

Preprint

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“…The purpose of our study was to examine neuroretinal function in NF1 patients without OPGs compared to a group of HCs by the use of mfERG. The mfERG is a validated methodology for clinical evaluation of several conditions, including retinitis pigmentosa, hydroxychloroquine toxicity, glaucoma, ocular vascular occlusive disorders [22][23][24][25][26][27] . Reveling subclinical abnormalities of retinal function, mfERG can identify patients at risk of retinal damage progression allowing for early therapeutic interventions [28][29][30][31] .…”

Section: Discussionmentioning

confidence: 99%

Neuroretinal Dysfunction in Patients Affected by Neurofibromatosis Type 1

Moramarco

Lucchino

Mallone

et al. 2021

Preprint

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The aim of the study was to examine neuroretinal function by using the mfERG test in patients with neurofibromatosis type 1 (NF1) without optic pathway gliomas (OPGs). This study was conducted on 35 patients (35 eyes) with NF1 and 30 healthy subjects (30 eyes) for the control group. Each subject underwent a complete ophthalmological examination including multifocal electroretinography (mfERG). 1.5-Tesla magnetic resonance imaging (MRI) scan of the brain was performed in NF1 patients to assess the presence of OPGs. All participants were recruited having a best corrected visual acuity (BCVA) of no less than 20/20 in each eye. The amplitude and implicit time of the P1 wave (first-order Kernel component) were evaluated on mfERG. Data analysis was carried out in the two central degrees and in the four quadrants from two to 25 degrees of visual field. Statistically significant results were obtained for the P1 wave amplitudes in the 4 quadrants in NF1 patients compared to healthy subjects, while the reduction was not significant in the 2 central degrees. A statistically significant difference was observed among the P1 wave amplitudes as recorded in the 4 quadrants within the NF1 group, with lower amplitudes in the nasal quadrants. No differences in the implicit times were recorded in the 4 quadrants and in the 2 central degrees as compared between NF1 patients and controls. The present study demonstrates impaired neuroretinal function in NF1 patients. Altered intracellular signal transduction due to abnormal neurofibromin-mediated cyclic adenosine monophosphate (cAMP) generation, could be involved. Our results suggest a possible use of mfERG as subclinical retinal damage indicator with a potential utility in clinical practice for the follow-up of NF1 patients.

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“…The antimalarial drugs chloroquine and hydroxychloroquine are currently used to treat autoimmune diseases for their immunomodulatory and anti-thrombotic properties [ 9 ]. Although chloroquine and hydroxychloroquine have also been proposed for the treatment of several viral infections, due to their antiviral effects in cell cultures and animal models [ 9 ], and, currently, for the treatment of COVID-19 [ 3 , [10] , [11] , [12] ]. The mechanism of action of chloroquine and its derivatives, both an antiviral and an anti-inflammatory, have not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

“…This kind of compounds has been tested against Malaria infection to explore more active compounds than chloroquine [ 19 ]. Many papers reported the effect of chloroquine and hydroxychloroquine in the treatment of COVID-19 [ 3 , 10 , 11 , 20 ], today these two drugs are used in different hospitals around the world as antiviral treatment of COVID-19 disease caused by SARS-CoV-2 virus [ 12 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of effective imidazole derivatives against SARS-CoV-2 main protease through computational approach

et al. 2020

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Because of the fast increase in deaths due to Corona Viral Infection in majority region in the world, the detection of drugs potent of this infection is a major need. With this idea, docking study was executed on eighteen imidazole derivatives based on 7-chloro-4-aminoquinoline against novel Coronavirus (SARS-CoV-2). In this study, we carried out a docking study of these molecules in the active site of SARS-CoV-2 main protease. The result indicate that Molecules N° 3, 7 and 14 have more binding energy with SARS-CoV-2 main protease recently crystallized (pdb code 6LU7 ) in comparison with the other imidazole derivatives and the two drug; Chloroquine and hydroxychloroquine. Because of the best energy of interaction, these three molecules could have the most potential antiviral treatment of COVID-19 than the other studied compounds. The structures with best affinity in the binding site of the protease have more than 3 cycles and electronegative atoms in the structure. This may increase the binding affinity of these molecules because of formation of π-bonds, halogen interactions and/or Hydrogen bond interactions between compounds and the enzyme. So, compounds with more cycles and electronegative atoms could have a potent inhibition of SARS-CoV-2 main protease.

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The Diagnostic Utility of Multifocal Electroretinography in Detecting Chloroquine and Hydroxychloroquine Retinal Toxicity

Cited by 31 publications

References 22 publications

Evaluation of optical coherence tomography angiography parameters in patients treated with hydroxychloroquine

Evaluation of optical coherence tomography angiography parameters in patients treated with hydroxychloroquine

Neuroretinal Dysfunction in Patients Affected by Neurofibromatosis Type 1

Assessment of effective imidazole derivatives against SARS-CoV-2 main protease through computational approach

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