For screening of hydroxychloroquine retinopathy, which combination of investigations is recommended once the drug has been taken for more than five years?
- A Fundus photography and FFA annually
- B 10-2 automated visual field testing and spectral-domain OCT annually ✓
- C Full-field ERG and dark adaptation annually
- D 30-2 automated visual field testing and Goldmann perimetry annually
Correct answer: B. 10-2 automated visual field testing and spectral-domain OCT annually
Explanation
Hydroxychloroquine toxicity affects the parafoveal and pericentral macula, so the 10-2 program, which tests points close to fixation, is more sensitive than the 24-2 or 30-2 programs used for glaucoma. Spectral-domain OCT detects early outer retinal disruption such as the flying saucer lesion and ellipsoid zone loss before functional defects appear. Asian patients show extrafoveal involvement, where widefield OCT and 30-2 fields are added. Fundus autofluorescence is a useful adjunct but the core pair is 10-2 perimetry with SD-OCT.
Reference: Yanoff and Duker Ophthalmology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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