Electrophysiologic findings in chloroquine maculopathy

• Published in: Documenta ophthalmologica Vol. 115; no. 2; pp. 117 - 119
• Main Authors: FURTADO DE MENDONCA, Regina Halfeld, MAIA JUNIOR, Otacilio Oliveira, YUKIHIKO TAKAHASHI, Walter
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01-09-2007; Springer Nature B.V
• Subjects: Antirheumatic Agents - adverse effects; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Biological and medical sciences; Chloroquine - adverse effects; Chloroquine - therapeutic use; Diseases of the osteoarticular system; Diseases of visual field, optic nerve, optic chiasma and optic tracts; Electrodiagnosis; Electrooculography; Electroretinography - methods; Humans; Inflammatory joint diseases; Macula Lutea - drug effects; Male; Medical sciences; Middle Aged; Ophthalmology; Retinal Diseases - chemically induced; Retinal Diseases - diagnosis; Retinal Diseases - physiopathology; Retinopathies; Scotoma - diagnosis; Scotoma - etiology; Visual Fields; Antimalarial; Retinopathy; Chloroquine; Diseases of the osteoarticular system; Electrophysiology; Autoimmune disease; Male; Inflammatory joint disease; Maculopathy; Electrodiagnosis; Daily; Reduction; Visual field disease; Test; Antirheumatic agent; EOG; Electroretinography; Human; Immunopathology; Bull eye maculopathy; Report; Visual field; Scotoma; Management; Medical screening; Normal; mfERG; Case study; Screening; Eye disease; Chronic; Area; Clinical management; Rheumatoid arthritis; Visual field defect; Parasiticide
• ISSN: 0012-4486; 1573-2622
• DOI: 10.1007/s10633-007-9060-2

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.
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.
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.