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Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates

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Abstract

Chloroquine (CQ) and hydroxycholorquine (HCQ) have been used widely for the treatment of rheumatoid arthritis and other similar inflammatory diseases since the early 50s. They remain the treatment of choice for many patients even today. Significant, either reversible or irreversible central visual loss associated with the drugs is very rare, but an important side effect that can warrant discontinuation of therapy. Early diagnosis of toxicity and evaluation of the visual function are, therefore, important parts of the treatment process. Various electrophysiological and psychophysical tests have been and are used for the detection, follow-up and prognosis of drug-associated central visual loss. A summary and comment on the tests, with emphasis on the use of more recently developed methods, such as the multifocal electroretinography (mfERG), are presented in this review.

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Abbreviations

CQ:

chloroquine

EOG:

electrooculgraphy

ERG:

electroretinography

HCQ:

hyroxychloroquine

RA:

rheumatoid arthritis

References

  1. The History of Malaria, an Ancient Disease. Atlanta, GA: Centers for Disease Control and Prevention

  2. LS Goodman A Gilman (1975) The Pharmacological Basis of Therapeutics Macmillan New York 1049–64

    Google Scholar 

  3. AL Scherbel JW Harrison M Atdjian (1958) ArticleTitleFurther observations on the use of 4-aminoquinoline compounds in patients with rheumatoid arthritis or related diseases Cleve Clin Q 25 95–111 Occurrence Handle13523829

    PubMed  Google Scholar 

  4. EW McChesney (1983) ArticleTitleAnimal toxicity and pharmacokinetics of hydroxychloroquine sulfate Am J Med 75 11–8 Occurrence Handle10.1016/0002-9343(83)91265-2 Occurrence Handle6408923

    Article  PubMed  Google Scholar 

  5. M Easterbrook (1988) ArticleTitleOcular effects and safety of antimalarial agents Am J Med 85 23–9 Occurrence Handle10.1016/0002-9343(88)90358-0

    Article  Google Scholar 

  6. M Tanaka H Takashina S Tsutsumi (2004) ArticleTitleComparative assessment of ocular tissue distribution of drug-related radioactivity after chronic oral administration of 14C-levofloxacin and 14C-chloroquine in pigmented rats J Pharm Pharmacol 56 977–83 Occurrence Handle10.1211/0022357043932 Occurrence Handle15285841

    Article  PubMed  Google Scholar 

  7. LL Gustafsson O Walker G Alvan B Beermann F Estevez L Gleisner B Lindstrom F Sjoqvist (1983) ArticleTitleDisposition of chloroquine in man after single intravenous and oral doses Br J Clin Pharmacol 15 471–9 Occurrence Handle6849784

    PubMed  Google Scholar 

  8. EI Ette EA Brown-Awala EE Essien (1987) ArticleTitleChloroquine elimination in humans: effect of low-dose cimetidine J Clin Pharmacol 27 813–6 Occurrence Handle3323258

    PubMed  Google Scholar 

  9. SE Tett DJ Cutler RO Day KF Brown (1989) ArticleTitleBioavailability of hydroxychloroquine tablets in healthy volunteers Br J Clin Pharmacol 27 771–9 Occurrence Handle2757893

    PubMed  Google Scholar 

  10. ML Estes D Ewing-Wilson SM Chou H Mitsumoto M Hanson E Shirey NB Ratliff (1987) ArticleTitleChloroquine neuromyotoxicity. Clinical and pathologic perspective Am J Med 82 447–55 Occurrence Handle10.1016/0002-9343(87)90444-X Occurrence Handle3826099

    Article  PubMed  Google Scholar 

  11. RI Rynes (1997) Antimalarial drugs WN Kelley ED Harris S Ruddy CB Sledge (Eds) Textbook of Rheumatology W.B. Saunders Co. Philadelphia 747–58

    Google Scholar 

  12. RI Rynes (1992) Antimalarials JS Dixon DE Furst (Eds) Second-line Agents in the Treatment of Rheumatic Diseases Marcel Dekker Inc. New York 245–66

    Google Scholar 

  13. A Cambiaggi (1957) ArticleTitleUnusual ocular lesions in a case of systemic lupus erythematosus AMA Arch Ophthalmol 57 451–3 Occurrence Handle13410231

    PubMed  Google Scholar 

  14. HN Bernstein (1967) ArticleTitleChloroquine ocular toxicity Surv Ophthalmol 12 415–47 Occurrence Handle4980087

    PubMed  Google Scholar 

  15. Fishman GA. Retinal toxicity with the use of chloroquine and hydroxychloroquine. In: Heckenlivley JR, Arden GB, eds. Principles and Practive of Clinical Electrophysiology of Vision. Mosby, 1991: 594–99

  16. M Easterbrook (1990) ArticleTitleIs corneal deposition of antimalarial any indication of retinal toxicity? Can J Ophthalmol 25 249–51 Occurrence Handle2207871

    PubMed  Google Scholar 

  17. JR Lozier MH Friedlaender (1989) ArticleTitleComplications of antimalarial therapy Int Ophthalmol Clin 29 172–8 Occurrence Handle2666332

    PubMed  Google Scholar 

  18. RI Rynes (1983) ArticleTitleOphthalmologic safety of long-term hydroxychloroquine sulfate treatment Am J Med 75 35–9 Occurrence Handle10.1016/0002-9343(83)91268-8

    Article  Google Scholar 

  19. DR Tobin G Krohel RI Rynes (1982) ArticleTitleHydroxychloroquine. Seven-year experience Arch Ophthalmol 100 81–3 Occurrence Handle7055472

    PubMed  Google Scholar 

  20. HE Hobbs A Sorsby A Freedman (1959) ArticleTitleRetinopathy following chloroquine therapy Lancet 2 478 Occurrence Handle10.1016/S0140-6736(59)90604-X Occurrence Handle14402143

    Article  PubMed  Google Scholar 

  21. M Easterbrook (1999) ArticleTitleAn ophthalmological view on the efficacy and safety of chloroquine versus hydroxychloroquine J Rheumatol 26 1866–8 Occurrence Handle10493662

    PubMed  Google Scholar 

  22. M Easterbrook (1999) ArticleTitleDetection and prevention of maculopathy associated with antimalarial agents Int Ophthalmol Clin 39 49–57 Occurrence Handle10343924

    PubMed  Google Scholar 

  23. GB Arden H Kolb (1966) ArticleTitleAntimalarial therapy and early retinal changes in patients with rheumatoid arthritis Br Med J 5482 270–3 Occurrence Handle5902055

    PubMed  Google Scholar 

  24. U Nylander (1967) ArticleTitleOcular damage in chloroquine therapy Acta Ophthalmol (Copenh) Suppl 92 1–71

    Google Scholar 

  25. RE Carr P Henkind N Rothfield IM Siegel (1968) ArticleTitleOcular toxicity of antimalarial drugs. Long-term follow-up Am J Ophthalmol 66 738–44 Occurrence Handle5729592

    PubMed  Google Scholar 

  26. PV Mills M Beck BJ Power (1981) ArticleTitleAssessment of the retinal toxicity of hydroxychloroquine Trans Ophthalmol Soc UK 101 109–13 Occurrence Handle6964214

    PubMed  Google Scholar 

  27. AH Mackenzie (1983) ArticleTitleDose refinements in long-term therapy of rheumatoid arthritis with antimalarials Am J Med 75 40–5 Occurrence Handle10.1016/0002-9343(83)91269-X

    Article  Google Scholar 

  28. M Mantyjarvi (1985) ArticleTitleHydroxychloroquine treatment and the eye Scand J Rheumatol 14 171–4 Occurrence Handle4001889

    PubMed  Google Scholar 

  29. HN Bernstein (1992) ArticleTitleOcular safety of hydroxychloroquine sulfate (Plaquenil) South Med J 85 274–9 Occurrence Handle1546352

    PubMed  Google Scholar 

  30. M Easterbrook (1992) ArticleTitleLong-term course of antimalarial maculopathy after cessation of treatment Can J Ophthalmol 27 237–9 Occurrence Handle1393809

    PubMed  Google Scholar 

  31. GD Levy SJ Munz J Paschal HB Cohen KJ Pince T Peterson (1997) ArticleTitleIncidence of hydroxychloroquine retinopathy in 1,207 patients in a large multicenter outpatient practice Arthritis Rheum 40 1482–6 Occurrence Handle9259429

    PubMed  Google Scholar 

  32. JA Block (1998) ArticleTitleHydroxychloroquine and retinal safety Lancet 351 771 Occurrence Handle10.1016/S0140-6736(05)78925-X

    Article  Google Scholar 

  33. K May T Metcalf A Gough (1998) ArticleTitleScreening for hydroxychloroquine retinopathy. Screening should be selective BMJ 317 1388–9

    Google Scholar 

  34. C Blyth C Lane (1998) ArticleTitleHydroxychloroquine retinopathy: is screening necessary? BMJ 316 716–7 Occurrence Handle9529393

    PubMed  Google Scholar 

  35. A Fielder E Graham S Jones A Silman A Tullo (1998) ArticleTitleRoyal College of Ophthalmologists guidelines: ocular toxicity and hydroxychloroquine Eye 12 IssueIDPt 6 907–9 Occurrence Handle10325983

    PubMed  Google Scholar 

  36. M Easterbrook (2001) ArticleTitleHydroxychloroquine retinopathy Ophthalmology 108 2158–9 Occurrence Handle10.1016/S0161-6420(01)00915-0 Occurrence Handle11733247

    Article  PubMed  Google Scholar 

  37. DJ Browning (2002) ArticleTitleHydroxychloroquine and chloroquine retinopathy: screening for drug toxicity Am J Ophthalmol 133 649–56 Occurrence Handle10.1016/S0002-9394(02)01392-2 Occurrence Handle11992862

    Article  PubMed  Google Scholar 

  38. PJ Penrose RT Tzekov EE Sutter AD Fu AW Allen SuffixJr. WE Fung KW Oxford (2003) ArticleTitleMultifocal electroretinography evaluation for early detection of retinal dysfunction in patients taking hydroxychloroquine Retina 23 503–12 Occurrence Handle10.1097/00006982-200308000-00010 Occurrence Handle12972762

    Article  PubMed  Google Scholar 

  39. RK Maturi M Yu RG Weleber (2004) ArticleTitleMultifocal electroretinographic evaluation of long-term hydroxychloroquine users Arch Ophthalmol 122 973–81 Occurrence Handle10.1001/archopht.122.7.973 Occurrence Handle15249360

    Article  PubMed  Google Scholar 

  40. HS Weisinger K Pesudovs HB Collin (2000) ArticleTitleManagement of patients undergoing hydroxychloroquine (Plaquenil) therapy Clin Exp Optom 83 32–36 Occurrence Handle12472464

    PubMed  Google Scholar 

  41. MF Marmor RE Carr M Easterbrook AA Farjo WF Mieler (2002) ArticleTitleRecommendations on screening for chloroquine and hydroxychloroquine retinopathy: a report by the American Academy of Ophthalmology Ophthalmology 109 1377–82 Occurrence Handle10.1016/S0161-6420(02)01168-5 Occurrence Handle12093666

    Article  PubMed  Google Scholar 

  42. JR Brinkley SuffixJr. EL Dubois SJ Ryan (1979) ArticleTitleLong-term course of chloroquine retinopathy after cessation of medication Am J Ophthalmol 88 1–11 Occurrence Handle463998

    PubMed  Google Scholar 

  43. MW Johnson AK Vine (1987) ArticleTitleHydroxychloroquine therapy in massive total doses without retinal toxicity Am J Ophthalmol 104 139–44 Occurrence Handle3618711

    PubMed  Google Scholar 

  44. A Weiner MA Sandberg AR Gaudio MM Kini EL Berson (1991) ArticleTitleHydroxychloroquine retinopathy Am J Ophthalmol 112 528–34 Occurrence Handle1951589

    PubMed  Google Scholar 

  45. M Mavrikakis S Papazoglou PP Sfikakis G Vaiopoulos K Rougas (1996) ArticleTitleRetinal toxicity in long term hydroxychloroquine treatment Ann Rheum Dis 55 187–9 Occurrence Handle8712882

    PubMed  Google Scholar 

  46. D Bienfang JS Coblyn MH Liang M Corzillius (2000) ArticleTitleHydroxychloroquine retinopathy despite regular ophthalmologic evaluation: a consecutive series J Rheumatol 27 2703–6 Occurrence Handle11093457

    PubMed  Google Scholar 

  47. DFW Wetterholm (1964) ArticleTitleHistopathology of chloroquine retinal toxicity Arch Ophthalmol 71 82 Occurrence Handle14066046

    PubMed  Google Scholar 

  48. MS Ramsey BS Fine (1972) ArticleTitleChloroquine toxicity in the human eye. Histopathologic observations by electron microscopy Am J Ophthalmol 73 229–35 Occurrence Handle4335678

    PubMed  Google Scholar 

  49. AR Rosenthal H Kolb D Bergsma D Huxsoll JL Hopkins (1978) ArticleTitleChloroquine retinopathy in the rhesus monkey Invest Ophthalmol Vis Sci 17 1158–75 Occurrence Handle102610

    PubMed  Google Scholar 

  50. BJ Hodgkinson H Kolb (1970) ArticleTitleA preliminary study of the effect of chloroquine on the rat retina Arch Ophthalmol 84 509–15 Occurrence Handle5492461

    PubMed  Google Scholar 

  51. LM Gonasun AM Potts (1974) ArticleTitleIn vitro inhibition of protein synthesis in the retinal pigment epithelium by chloroquine Invest Ophthalmol 13 107–15 Occurrence Handle4811618

    PubMed  Google Scholar 

  52. JL Goldstein GY Brunschede MS Brown (1975) ArticleTitleInhibition of proteolytic degradation of low density lipoprotein in human fibroblasts by chloroquine, concanavalin A, and Triton WR 1339 J Biol Chem 250 7854–62 Occurrence Handle170273

    PubMed  Google Scholar 

  53. VM Elner T Schaffner K Taylor S Glagov (1981) ArticleTitleImmunophagocytic properties of retinal pigment epithelium cells Science 211 74–6 Occurrence Handle7444450

    PubMed  Google Scholar 

  54. H Kuhn P Keller E Kovacs A Steiger (1981) ArticleTitleLack of correlation between melanin affinity and retinopathy in mice and cats treated with chloroquine or flunitrazepam Albrecht Von Graefes Arch Klin Exp Ophthalmol 216 177–90 Occurrence Handle10.1007/BF00408159 Occurrence Handle6113787

    Article  PubMed  Google Scholar 

  55. B Leblanc S Jezequel T Davies G Hanton C Taradach (1998) ArticleTitleBinding of drugs to eye melanin is not predictive of ocular toxicity Regul Toxicol Pharmacol 28 124–32 Occurrence Handle10.1006/rtph.1998.1243 Occurrence Handle9927562

    Article  PubMed  Google Scholar 

  56. TA Ivanina MV Zueva MN Lebedeva AI Bogoslovsky AJ Bunin (1983) ArticleTitleUltrastructural alterations in rat and cat retina and pigment epithelium induced by chloroquine Graefes Arch Clin Exp Ophthalmol 220 32–8 Occurrence Handle6832596

    PubMed  Google Scholar 

  57. MH Gregory DA Rutty RD Wood (1970) ArticleTitleDifferences in the retinotoxic action of chloroquine and phenothiazine derivatives J Pathol 102 139–50 Occurrence Handle10.1002/path.1711020304 Occurrence Handle5508910

    Article  PubMed  Google Scholar 

  58. L Tanenbaum DL Tuffanelli (1980) ArticleTitleAntimalarial agents. Chloroquine, hydroxychloroquine, and quinacrine Arch Dermatol 116 587–91 Occurrence Handle10.1001/archderm.116.5.587 Occurrence Handle6990871

    Article  PubMed  Google Scholar 

  59. G Duncker M Schmiederer T Bredehorn (1995) ArticleTitleChloroquine-induced lipidosis in the rat retina: a functional and morphological study Ophthalmologica 209 79–83 Occurrence Handle7746650

    PubMed  Google Scholar 

  60. G Duncker T Bredehorn (1996) ArticleTitleChloroquine-induced lipidosis in the rat retina: functional and morphological changes after withdrawal of the drug Graefes Arch Clin Exp Ophthalmol 234 378–81 Occurrence Handle10.1007/BF00190714 Occurrence Handle8738704

    Article  PubMed  Google Scholar 

  61. A Gonzalez-Noriega JH Grubb V Talkad WS Sly (1980) ArticleTitleChloroquine inhibits lysosomal enzyme pinocytosis and enhances lysosomal enzyme secretion by impairing receptor recycling J Cell Biol 85 839–52 Occurrence Handle10.1083/jcb.85.3.839 Occurrence Handle7190150

    Article  PubMed  Google Scholar 

  62. M Yanoff KC Tsou (1965) ArticleTitleA tetrazolium study of the whole eye: effect of chloroquine in the incubation medium Am J Ophthalmol 59 808–10 Occurrence Handle14288919

    PubMed  Google Scholar 

  63. A Wada S Sakurai H Kobayashi N Yanagihara F Izumi (1983) ArticleTitleSuppression by phospholipase A2 inhibitors of secretion of catecholamines from isolated adrenal medullary cells by suppression of cellular calcium uptake Biochem Pharmacol 32 1175–8 Occurrence Handle10.1016/0006-2952(83)90267-8 Occurrence Handle6847709

    Article  PubMed  Google Scholar 

  64. JG Kench JP Seale DM Temple C Tennant (1985) ArticleTitleThe effects of non-steroidal inhibitors of phospholipase A2 on leukotriene and histamine release from human and guinea-pig lung Prostaglandins 30 199–208 Occurrence Handle10.1016/0090-6980(85)90185-6 Occurrence Handle2413502

    Article  PubMed  Google Scholar 

  65. R Nozik F Weinstock V PJr (1964) ArticleTitleOcular complications of chloroquine Am J Ophthalmol 58 774–778 Occurrence Handle14220489

    PubMed  Google Scholar 

  66. U Nylander (1966) ArticleTitleOcular damage in chloroquine therapy Acta Ophthalmol (Copenh) 44 335–48

    Google Scholar 

  67. P Henkind RE Carr IM Siegel (1964) ArticleTitleEarly chloroquine retinopathy: clincial and functional findings Am J Ophthalmol 71 157–165

    Google Scholar 

  68. BL Vu M Easterbrook JK Hovis (1999) ArticleTitleDetection of color vision defects in chloroquine retinopathy Ophthalmology 106 1799–803 Occurrence Handle10.1016/S0161-6420(99)90338-X Occurrence Handle10485553

    Article  PubMed  Google Scholar 

  69. P Grutzner (1969) ArticleTitleAcquired color vision defects secondary to retinal drug toxicity Ophthalmologica 158 IssueIDSuppl 592–604 Occurrence Handle5307973

    PubMed  Google Scholar 

  70. AS Neubauer K Samari-Kermani U Schaller U Welge-Lubetaen G Rudolph T Berninger (2003) ArticleTitleDetecting chloroquine retinopathy: electro-oculogram versus colour vision Br J Ophthalmol 87 902–8 Occurrence Handle10.1136/bjo.87.7.902 Occurrence Handle12812896

    Article  PubMed  Google Scholar 

  71. WM Hart SuffixJr. RM Burde GP Johnston RC Drews (1984) ArticleTitleStatic perimetry in chloroquine retinopathy. Perifoveal patterns of visual field depression Arch Ophthalmol 102 377–80 Occurrence Handle6703984

    PubMed  Google Scholar 

  72. SP Percival J Behrman (1969) ArticleTitleOphthalmological safety of chloroquine Br J Ophthalmol 53 101–9 Occurrence Handle5773461

    PubMed  Google Scholar 

  73. AE Krill AM Potts CE Johanson (1971) ArticleTitleChloroquine retinopathy. Investigation of discrepancy between dark adaptation and electroretinographic findings in advanced stages Am J Ophthalmol 71 530–43 Occurrence Handle5547534

    PubMed  Google Scholar 

  74. RE Carr P Gouras RD Gunkel (1966) ArticleTitleChloroquine retinopathy. Early detection by retinal threshold test Arch Ophthalmol 75 171–8 Occurrence Handle5903800

    PubMed  Google Scholar 

  75. M Easterbrook (1984) ArticleTitleThe use of Amsler grids in early chloroquine retinopathy Ophthalmology 91 1368–72 Occurrence Handle6514305

    PubMed  Google Scholar 

  76. M Easterbrook G Trope (1989) ArticleTitleValue of Humphrey perimetry in the detection of early chloroquine retinopathy Lens Eye Toxic Res 6 255–68 Occurrence Handle2488020

    PubMed  Google Scholar 

  77. M Easterbrook (1985) ArticleTitleThe sensitivity of Amsler grid testing in early chloroquine retinopathy Trans Ophthalmol Soc UK 104 IssueIDPt 2 204–7 Occurrence Handle3857780

    PubMed  Google Scholar 

  78. SA Mazzuca R Yung KD Brandt RD Yee BP Katz (1994) ArticleTitleCurrent practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil) therapy J Rheumatol 21 59–63 Occurrence Handle8151589

    PubMed  Google Scholar 

  79. M Easterbrook (1998) ArticleTitleCurrent concepts in monitoring patients on antimalarials Aust NZJ Ophthalmol 26 101–3

    Google Scholar 

  80. SA Bishara N Matamoros (1989) ArticleTitleEvaluation of several tests in screening for chloroquine maculopathy Eye 3 IssueIDPt 6 777–82 Occurrence Handle2630362

    PubMed  Google Scholar 

  81. GB Arden MR Fojas (1962) ArticleTitleElectrophysological abnormailities in pigmentary degenerations of the retina Arch Ophthalmol 68 369 Occurrence Handle13862110

    PubMed  Google Scholar 

  82. GB Arden A Friedmann H Kolb (1962) ArticleTitleAnticipation of chloroquine retinopathy Lancet 1 1164–5 Occurrence Handle10.1016/S0140-6736(62)92200-6 Occurrence Handle13862111

    Article  PubMed  Google Scholar 

  83. H Kolb (1965) ArticleTitleElectro-oculogram findings in patients treated with antimalarial drugs Br J Ophthalmol 49 573–90 Occurrence Handle5849422

    PubMed  Google Scholar 

  84. van Lith GH, Mak GT, Wijnands H. Clinical importance of the electro-oculogram with special reference to the chloroquine retinopathy. Bibl Ophthalmol 1976; 2–9

  85. CN Reijmer JG Tijssen GA Kok GH Lith Particlevan (1980) ArticleTitleInterpretation of the electro-oculogram of patients taking chloroquine Doc Ophthalmol 48 273–6 Occurrence Handle10.1007/BF00141453 Occurrence Handle7398528

    Article  PubMed  Google Scholar 

  86. HS Graniewski-Wijnands GH Lith Particlevan S Vijfvinkel-Bruinenga (1980) ArticleTitleOphthalmological examination of patients taking chloroquine Doc Ophthalmol 48 231–4 Occurrence Handle10.1007/BF00141446 Occurrence Handle7398523

    Article  PubMed  Google Scholar 

  87. MN Moschos MM Moschos M Apostolopoulos JA Mallias C Bouros GP Theodossiadis (2004) ArticleTitleAssessing hydroxychloroquine toxicity by the multifocal ERG Doc Ophthalmol 108 47–53 Occurrence Handle10.1023/B:DOOP.0000018385.99215.0d Occurrence Handle15104166

    Article  PubMed  Google Scholar 

  88. B Schmidt W Muller-Limroth (1962) ArticleTitleElectroretonographic examinations following the application of chloroquine Acta Ophtalmol 70 IssueIDSuppl 245

    Google Scholar 

  89. HN Bernstein (1983) ArticleTitleOphthalmologic considerations and testing in patients receiving long-term antimalarial therapy Am J Med 75 25–34 Occurrence Handle10.1016/0002-9343(83)91267-6 Occurrence Handle6869408

    Article  PubMed  Google Scholar 

  90. CA Burns (1968) ArticleTitleIndomethacin, reduced retinal sensitivity, and corneal deposits Am J Ophthalmol 66 825–35 Occurrence Handle5698437

    PubMed  Google Scholar 

  91. RE Carr IM Siegel (1973) ArticleTitleRetinal function in patients treated with indomethacin Am J Ophthalmol 75 302–6 Occurrence Handle4697185

    PubMed  Google Scholar 

  92. FW Sassaman JT Cassidy M Alpern F Maaseidvaag (1970) ArticleTitleElectroretinography in patients with connective tissue diseases treated with hydroxychloroquine Am J Ophthalmol 70 515–23 Occurrence Handle5505469

    PubMed  Google Scholar 

  93. L Wachtmeister (1998) ArticleTitleOscillatory potentials in the retina: what do they reveal Prog Retin Eye Res 17 485–521 Occurrence Handle10.1016/S1350-9462(98)00006-8 Occurrence Handle9777648

    Article  PubMed  Google Scholar 

  94. RT Tzekov A Serrato MF Marmor (2004) ArticleTitleERG findings in patients using hydroxychloroquine Doc Ophthalmol 108 87–97 Occurrence Handle10.1023/B:DOOP.0000018410.08802.d3 Occurrence Handle15104171

    Article  PubMed  Google Scholar 

  95. MA Johnson S Marcus MJ Elman TJ McPhee (1988) ArticleTitleNeovascularization in central retinal vein occlusion: electroretinographic findings Arch Ophthalmol 106 348–52 Occurrence Handle2449882

    PubMed  Google Scholar 

  96. R Tzekov GB Arden (1999) ArticleTitleThe electroretinogram in diabetic retinopathy Surv Ophthalmol 44 53–60 Occurrence Handle10.1016/S0039-6257(99)00063-6 Occurrence Handle10466588

    Article  PubMed  Google Scholar 

  97. EE Sutter D Tran (1992) ArticleTitleThe field topography of ERG components in man-I. The photopic luminance response Vision Res 32 433–46 Occurrence Handle10.1016/0042-6989(92)90235-B Occurrence Handle1604830

    Article  PubMed  Google Scholar 

  98. SC So TR Hedges JS Schuman ML Quireza (2003) ArticleTitleEvaluation of hydroxychloroquine retinopathy with multifocal electroretinography Ophthalmic Surg Lasers Imaging 34 251–8 Occurrence Handle12757106

    PubMed  Google Scholar 

  99. U Kellner H Kraus MH Foerster (2000) ArticleTitleMultifocal ERG in chloroquine retinopathy: regional variance of retinal dysfunction Graefes Arch Clin Exp Ophthalmol 238 94–7 Occurrence Handle10.1007/s004170050016 Occurrence Handle10664060

    Article  PubMed  Google Scholar 

  100. AS Neubauer S Stiefelmeyer T Berninger GB Arden G Rudolph (2004) ArticleTitleThe multifocal pattern electroretinogram in chloroquine retinopathy Ophthalmic Res 36 106–13 Occurrence Handle10.1159/000076890 Occurrence Handle15017107

    Article  PubMed  Google Scholar 

  101. Y Shimada Y Li MA Bearse SuffixJr. EE Sutter W Fung (2001) ArticleTitleAssessment of early retinal changes in diabetes using a new multifocal ERG protocol Br J Ophthalmol 85 414–9 Occurrence Handle10.1136/bjo.85.4.414 Occurrence Handle11264129

    Article  PubMed  Google Scholar 

  102. N Giordano M D’Ettorre G Biasi A Fioravanti L Moretti R Marcolongo (1990) ArticleTitleRetinal vasculitis in rheumatoid arthritis: an angiographic study Clin Exp Rheumatol 8 121–5 Occurrence Handle2338009

    PubMed  Google Scholar 

  103. R Santos E Barojas D Alarcon-Segovia G Ibanez (1975) ArticleTitleRetinal microangiopathy in systemic lupus erythematosus Am J Ophthalmol 80 249–52 Occurrence Handle1155563

    PubMed  Google Scholar 

  104. FJ Stafford-Brady MB Urowitz DD Gladman M Easterbrook (1988) ArticleTitleLupus retinopathy. Patterns, associations, and prognosis Arthritis Rheum 31 1105–10 Occurrence Handle3422014

    PubMed  Google Scholar 

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  1. Biological Sciences, RD2-2C Allergan Inc., 2525 Dupont Drive, Irvine, CA, 92612, USA

    Radouil Tzekov

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Tzekov, R. Ocular Toxicity Due to Chloroquine and Hydroxychloroquine: Electrophysiological and Visual Function Correlates. Doc Ophthalmol 110, 111–120 (2005). https://doi.org/10.1007/s10633-005-7349-6

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