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Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users
摘要： 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.
关键词： test-retest variability,hydroxychloroquine,multifocal electroretinography
更新于2025-09-19 17:15:36
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Exploring Test–Retest Variability Using High-Resolution Perimetry
摘要： Purpose: Test–retest variability (TRV) of visual field (VF) data seriously degrades our capacity to recognize true VF progression. We conducted repeated high-resolution perimetry with a test interval of 0.58 to investigate the sources of TRV. In particular, we examined whether the spatial variance of the observed sensitivity changes or if their absolute magnitude was of more importance. Methods: Sixteen eyes of 16 glaucoma patients were each tested three times at 61 VF locations along the superior-temporal 458 meridian using a modified protocol of the Octopus 900 perimeter. TRV was quantified as the standard deviation of the repeats at each point (retest-SD). We also computed the mean sensitivity at each point (retest-MS) and the running spatial-SD along the tested meridian. Multiple regression models investigated whether any of those variables (and also age, sex, and VF eccentricity) were significant independent determinants of TRV. Results: The main independent determinants of TRV were the retest-MS at (cid:2)0.04 dB TRV/dB loss (P , 0.0001, t-statistic 5.05), and the retest-SD at 0.47 dB spatial variance/dB loss (P , 0.0001, t-statistic 12.5). Conclusions: The larger effect for the spatial-SD suggested that it was perhaps a stronger determinant of TRV than scotoma depth per se. This might support the hypothesis that rapidly varying interactions between small perimetric stimuli, sensitivity across the field, and normal fixational jitter are strong determinants of TRV. Translational Relevance: Our study indicates that methods that might reduce the effects of jagged sensitivity changes, such as increasing stimulus size or better gaze tracking, could reduce TRV.
关键词： glaucoma,high-resolution perimetry,test–retest variability
更新于2025-09-04 15:30:14