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Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users

Authors Browning D, Lee C

Received 19 April 2014

Accepted for publication 27 May 2014

Published 7 August 2014 Volume 2014:8 Pages 1467—1473


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

David J Browning,1 Chong Lee2

1Charlotte Eye, Ear, Nose and Throat Associates, 2University of North Carolina – Charlotte, Charlotte, NC, USA

Purpose: To determine measurement variability of N1P1 amplitudes and the R1/R2 ratio in normal subjects and hydroxychloroquine users without retinopathy.
Design: Retrospective, observational study.
Subjects: Normal subjects (n=21) and 44 patients taking hydroxychloroquine (n=44) without retinopathy.
Methods: Multifocal electroretinography (mfERG) was performed twice in one session in the 21 normal subjects and twice within 1 year in the hydroxychloroquine users, during which time no clinical change in macular status occurred.
Main outcome measures: N1P1 amplitudes of rings R1–R5, the R1/R2 ratio, and coefficients of repeatability (COR) for these measurements.
Results: Values for N1P1 amplitudes in hydroxychloroquine users were reduced compared with normal subjects by the known effect of age, but R1/R2 was not affected by age. The COR for R1–R5 ranged from 43% to 52% for normal subjects and from 43% to 59% for hydroxychloroquine users; for R1/R2 the COR was 29% in normal subjects and 45% in hydroxychloroquine users.
Conclusion: mfERG measurements show high test-retest variability, limiting the ability of a single mfERG test to influence a decision to stop hydroxychloroquine; corroborative evidence with a different ancillary test is recommended in a suspicious case.

Keywords: multifocal electroretinography, hydroxychloroquine, test-retest variability

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