title: Antimalarial-induced maculopathy: accuracy of Amsler grid as a diagnostic tool and risk factors.
abstract: OBJECTIVE
  To determine the sensitivity, specificity, and agreement of Amsler grid (AG) in detecting antimalarial induced maculopathy (AM) compared to combination of dilated ocular examination and Humphrey visual field (HVF) 10-2 and to estimate the risk factors of AM.
  
  
  METHODS
  20 patients with AM and 20 patients with no AM were included between October 1, 2010 and June 30, 2011 in Siriraj Hospital, Thailand. Sensitivity, specificity and unweighted kappa were used to determine accuracy of AG. Logistic regression was used to explore risk factors associated with AM.
  
  
  RESULTS
  The sensitivity and specificity of AG were 40% and 100%, respectively. The agreement of AG and HVF 10-2 was poor with kappa of 0.4. Creatinine clearance < 60 ml/min/1.73 m2 and bilateral macular abnormality were associated with AM at the same odds ratio of 8.9 (95% confidence interval: 1.3 to 61.2).
  
  
  CONCLUSIONS
  AG may be used as an additional test between ocular evaluation visits providing the availability and low cost. Patients with renal impairment and bilateral macular abnormality are associated with AM.
authors.affiliation: Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sipco@mahidol.ac.th
authors.forename: Praveena
authors.initials: P
authors.lastname: Chiowchanwisawakit
authors.forename: Varalak
authors.initials: V
authors.lastname: Srinonprasert
authors.forename: Surasak
authors.initials: S
authors.lastname: Nilganuwong
authors.forename: Wanruchada
authors.initials: W
authors.lastname: Katchamart
authors.forename: Ajchara
authors.initials: A
authors.lastname: Koolvisoot
authors.forename: Emvalee
authors.initials: E
authors.lastname: Arromdee
authors.forename: Ngamkae
authors.initials: N
authors.lastname: Ruangvaravate
mesh_terms: D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000188:drug therapy; D012680:Sensitivity and Specificity; D058609:Visual Field Tests / Q000379:methods*
chemical_list: D000962:Antimalarials