Unit 6 - HQ screening

Question 1

What do we look for in HCQ retinopathy?

Answer 1

Thining of ONL
disruption of photoreceptor/EZ/IZ
Increased choroidal reflectance from RPE loss
Loss of space between EZ and IZ

Question 2

What % of patients will have a rign scotoma on visual field testing without OCT signs?

Answer 2

10%

Question 3

What patterns of FAF do you need to look for?

Answer 3

Hyper (RPE stress)
Hypo (RPE loss) late
Bull’s eye pattern

Question 4

What visual field defects should you look for?

Answer 4

Ring scotoma

Parafoveal damage

Question 5

Which test is the most sensitive for finding out HQ retinopathy?

Answer 5

Visual fields

Question 6

What are the 3 screening outcomes?

Answer 6

A - none
B - 1 test suspicious
C - 2 tests show suspicious findings (one subjective and one objective)

Question 7

What are the risk factors for HQ retiopathy?

Answer 7

Duration >10 years
Dose >5mg/kg
Kidney disease
Tamoxifen use
Chloroquine dose 2.3mg/kg

Question 8

When should screening commence?

Answer 8

After 5 years in low risk
Yearly if high risk

Question 9

Which visual field plot do we use?

Answer 9

10-2
30-2 if Asian

Question 10

What electrodiagnostic test can be used?

Answer 10

Multifocal ERG

Question 11

What is the sensitivity of OCT and FAF?

Answer 11

86%

Question 12

Which patients present with pericentral disease?

Answer 12

Asian

Question 13

Can toxicity continue after cessation of treatment?

Answer 13

Yes

Question 14

What 3 severity levels are there?

Answer 14

Mild PSD <3db, FAF subtle increase, subtle retinal changes
Moderate: PSD 3-10db, significant increase in FAF, outer retinal thinning
Severe: PSD >10db, complete ring scotoma, FAF 2 quadrants of RPE damage, outer retina and rpe changes, ERM and CMO may be present