Accuracy of Amsler grid in screening for chloroquine retinopathy
Suansilpong, A.; Uaratanawong, S.
Journal of the Medical Association of Thailand 93(4): 462-466
2010
ISSN/ISBN: 0125-2208 PMID: 20462090 Document Number: 10704
Determine the accuracy, sensitivity, and specificity of an Amsler grid testingfor chloroquine retinopathy screening. One hundred and forty patients who received chloroquine phosphate or hydroxychloroquine sulfate and attended the rheumatology clinic of BMA Medical College and Vajira Hospital between March 2008 and May 2009 were included. The patients underwent Amsler grid testing, which would be interpreted by a rheumatologist, for any evidence of chloroquine retinopathy. The resultsfrom Amsler grid testing were then compared to the results from a Humphrey 10-2 fields testing, which was subsequently performed by an experienced ophthalmologist and was used as a gold standard. Out of 140 patients, chloroquine retinopathy was evidenced in 11 patients (7.9%). Kappa value of the Amsler grid testing interpreted by rheumatologist and the Humphrey 10-2 fields testing interpreted by ophthalmologist was 0.89. The accuracy for screening chloroquine retinopathy by the Amsler grid testing was 98.6% (95% confidence interval [CI], 98.1-100.0%) with the sensitivity of81.8% (95% CI, 75.4-88.2%). The specificity and positive predictive value were 100.0% while the negative predictive value was 98.4% (95% CI, 96.4-100.0%). Amsler grid testing is an accurate screening test for chloroquine retinopathy with very high specificity. The test could be achieved by a rheumatologist who could practically serve the patients in one visit at the rheumatology clinic.
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