Electroretinography Findings in Patients Treated with Hydroxychloroquine

Abstract

Background: Hydroxychloroquine (HCQ) is frequently prescribed for managing rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis. However, prolonged use of HCQ has been linked to retinal toxicity. Objective: To assess retinal changes in patients receiving HCQtreatment using multifocal electroretinogram (mfERG). Methods: This cross-sectional study included forty Egyptian patients with a history of one year or more of HCQ intake for conditions like systemic lupus erythematosus or rheumatoid arthritis. Patients underwent complete ophthalmic examinations and were subsequently evaluated using multifocal electroretinogram. Results: There was no statistically significant difference in multifocal ERG abnormalities concerning the age distribution among the studied patients (P>0.05). However, a statistically significant difference was observed between mfERG abnormalities and the duration of HCQ treatment (P<0.05). Notably, patients with paracentral depression had the longest treatment duration. Conclusions: The study findings indicate that multifocal ERG serves as a valuable screening tool for early detection of HCQ retinopathy, detecting signal depression, primarily in the paracentral region, in patients treated with HCQ for over 5 years. Importantly, even visually asymptomatic patients with no fundus abnormalities may exhibit abnormal results on mfERG.