Macular sensitivity changes for detection of chloroquine toxicity in asymptomatic patient.
OBJECTIVE
To describe the efficacy of microperimetry (MP-1) in detecting early retinal toxicity as a result of chronic use of chloroquine and in monitoring the changes in macular sensitivity in an asymptomatic patient with best-corrected visual acuity of 20/20 bilaterally.


METHODS
A 60-year-old woman presented for routine ocular examination with a medical history of severe rheumatoid arthritis, for which she had been receiving 3 mg chloroquine (CQ) per kilogram for the past 17 years. The patient was asymptomatic with best-corrected visual acuity of 20/20 bilaterally.


RESULTS
Microperimeter showed loss of sensitivity in the macular region with a dense scotoma within the central 12 degrees (2.80 +/- 4.7 dB right eye and 2.84 +/- 4.7 dB left eye). CQ treatment was discontinued and substituted by Plaquenil.


CONCLUSIONS
Chloroquine retinal toxicity can be recognized in a subclincal form by the presence of early changes in macular sensitivity, detected by MP-1.
Angi
Martina
M
St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK.
Romano
Vito
V
Valldeperas
Xavier
X
Romano
Ferdinando
F
Romano
Mario R
MR
D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002738:Chloroquine / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D005403:Fixation, Ocular; D006801:Humans; D008266:Macula Lutea / Q000187:drug effects / Q000503:physiopathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D012607:Scotoma / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D014792:Visual Acuity; D058609:Visual Field Tests / Q000379:methods
D018501:Antirheumatic Agents; D002738:Chloroquine