Optical Coherence Tomography Minimum Intensity as an Objective Measure for the Detection of Hydroxychloroquine Toxicity
| Autor: | Ali M. Allahdina, Wai T. Wong, Susan Vitale, Catherine A Cukras, F.L. Ferris, Emily Y. Chew, Paul F. Stetson, Paul A. Sieving |
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| Rok vydání: | 2018 |
| Předmět: |
Male
genetic structures Visual Acuity Ophthalmology & Optometry Medical and Health Sciences chemistry.chemical_compound 0302 clinical medicine Prospective Studies Prospective cohort study Tomography medicine.diagnostic_test Area under the curve Diabetic retinopathy Biological Sciences Middle Aged 3. Good health Antirheumatic Agents Toxicity Female Tomography Optical Coherence medicine.drug Adult medicine.medical_specialty hydroxychloroquine Sensitivity and Specificity Retina 03 medical and health sciences Optical coherence tomography Retinal Diseases Ophthalmology Rheumatic Diseases medicine Electroretinography Humans Aged 030203 arthritis & rheumatology optical coherence tomography business.industry Hydroxychloroquine Retinal medicine.disease eye diseases chemistry retina toxicity Optical Coherence Case-Control Studies 030221 ophthalmology & optometry sense organs Visual Fields business |
| Zdroj: | Investigative Ophthalmology & Visual Science Investigative ophthalmology & visual science, vol 59, iss 5 |
| ISSN: | 1552-5783 |
| Popis: | Author(s): Allahdina, Ali M; Stetson, Paul F; Vitale, Susan; Wong, Wai T; Chew, Emily Y; Ferris, Fredrick L; Sieving, Paul A; Cukras, Catherine | Abstract: Purpose:As optical coherence tomography (OCT) minimum intensity (MI) analysis provides a quantitative assessment of changes in the outer nuclear layer (ONL), we evaluated the ability of OCT-MI analysis to detect hydroxychloroquine toxicity. Methods:Fifty-seven predominantly female participants (91.2% female; mean age, 55.7 ± 10.4 years; mean time on hydroxychloroquine, 15.0 ± 7.5 years) were enrolled in a case-control study and categorized into affected (i.e., with toxicity, n = 19) and unaffected (n = 38) groups using objective multifocal electroretinographic (mfERG) criteria. Spectral-domain OCT scans of the macula were analyzed and OCT-MI values quantitated for each subfield of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. A two-sample U-test and a cross-validation approach were used to assess the sensitivity and specificity of toxicity detection according to OCT-MI criteria. Results:The medians of the OCT-MI values in all nine of the ETDRS subfields were significantly elevated in the affected group relative to the unaffected group (P l 0.005 for all comparisons), with the largest difference found for the inner inferior subfield (P l 0.0001). The receiver operating characteristic analysis of median MI values of the inner inferior subfields showed high sensitivity and high specificity in the detection of toxicity with area under the curve = 0.99. Conclusions:Retinal changes secondary to hydroxychloroquine toxicity result in increased OCT reflectivity in the ONL that can be detected and quantitated using OCT-MI analysis. Analysis of OCT-MI values demonstrates high sensitivity and specificity for detecting the presence of hydroxychloroquine toxicity in this cohort and may contribute additionally to current screening practices. |
| Databáze: | OpenAIRE |
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