Abstract
Purpose To describe an interesting case with a typical chloroquine bull’s eye maculopathy with important results of the electrophysiological tests and verify if any reduction of focal responses, detected in multifocal electroretinogram (mfERG), are congruent with any possible defects detected in the visual field. Case report A 59-year-old man took a daily dosage of 250 mg chloroquine for his rheumatoid arthritis (up to a total dose of 540 g). He had the typical chloroquine-induced bull’s-eye maculopathy. The electro-oculogram was normal. The mfERG, demonstrated reduced focal responses in the areas corresponding to the scotoma detected in the visual field. Conclusions Considering the normality of the electro-oculogram, we can easily conclude that the electro-oculogram is not sensible to detect chloroquine maculopathy and that reported reductions may occur due to the course of the rheumatoid arthritis itself. The mfERG may be an important ophthalmological screening and follow-up management to investigate patients using chloroquine.
References
Gouras P, Gunkel RD (1963) The EOG in chloroquine and other retinopathies. Arch Ophthalmol 70:629–639
Kolb H (1965) Electro-oculogram findings in patients treated with antimalarial drugs. Br J Ophthalmol 49:573–589
Reijmer CN, Tijssen JG, Kok GA et al (1980) Interpretation of the electro-oculogram of patients taking chloroquine. Doc Ophthalmol 48:273–276
Graniewski-Wijnands HS, van Lith GH, Vijfvinkel-Bruinenga S (1980) Ophthalmological examination of patients taking chloroquine. Doc Ophthalmol 48:231–234
Moschos MN, Moschos MM, Apostolopoulos M et al (2004) Assessing hydroxychloroquine toxicity by the multifocal ERG. Doc Ophthalmol 108:47–53
Cursiefen C, Grunert U, Junemann A (1997) Chloroquine-induced bull’s eye maculopathy without electrophysiologic changes. Klin Monatsbl Augenheilkd 210:400–401
Neubauer AS, Samari-Kermani K, Schaller U et al (2003) Detecting chloroquine retinopathy: electro-oculogram versus colour vision. Br J Ophthalmol 87:902–908
Rigaudiere F, Pizzato M, Albuisson E et al (1990) Statistical results of 700 electrophysiologic tests (ERG) in patients without ophthalmologic manifestations treated with synthetic antimalarials for rheumatologic or dermatologic disease. Ophtalmologie 4:254–259
Matsuo T, Koyama T, Morimoto N et al (1990) Retinal vasculitis as a complication of rheumatoid arthritis. Ophthalmologica 201:196–200
Matsuo T, Masuda I, Matsuo N (1998) Geographic choroiditis and retinal vasculitis in rheumatoid arthritis. Jpn J Ophthalmol 42:51–55
Giordano N, D′Ettorre M, Biasi G et al (1990) Retinal vasculitis in rheumatoid arthritis: an angiographic study. Clin Exp Rheumatol 8:121–125
Kellner U, Kraus H, Foerster MH (2000) Multifocal ERG in chloroquine retinopathy: regional variance of retinal dysfunction. Graefes Arch Clin Exp Ophthalmol 238:94–97
Maturi RK, Yu M, Weleber RG (2004) Multifocal electroretinographic evaluation of long-term hydroxychloroquine users. Arch Ophthalmol 122:973–981
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Halfeld Furtado de Mendonça, R., Oliveira Maia Júnior, O. & Yukihiko Takahashi, W. Electrophysiologic findings in chloroquine maculopathy. Doc Ophthalmol 115, 117–119 (2007). https://doi.org/10.1007/s10633-007-9060-2
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DOI: https://doi.org/10.1007/s10633-007-9060-2