1. Oculometric biomarkers of visuomotor deficits in clinically asymptomatic patients with systemic lupus erythematosus undergoing long-term hydroxychloroquine treatment.
- Author
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Berneshawi AR, Seyedmadani K, Goel R, Anderson MR, Tyson TL, Akay YM, Akay M, Leung LB, and Stone LS
- Abstract
Introduction: This study examines a set of oculomotor measurements, or "oculometric" biomarkers, as potential early indicators of visual and visuomotor deficits due to retinal toxicity in asymptomatic Systemic Lupus Erythematosus (SLE) patients on long-term hydroxychloroquine (HCQ) treatment. The aim is to identify subclinical functional impairments that are otherwise undetectable by standard clinical tests and to link them to structural retinal changes., Methods: We measured oculomotor responses in a cohort of SLE patients on chronic HCQ therapy using a previously established behavioral task and analysis technique. We also examined the relationship between oculometrics, OCT measures of retinal thickness, and standard clinical perimetry measures of visual function in our patient group using Bivariate Pearson Correlation and a Linear Mixed-Effects Model (LMM)., Results: Significant visual and visuomotor deficits were found in 12 asymptomatic SLE patients on long-term HCQ therapy compared to a cohort of 17 age-matched healthy controls. Notably, six oculometrics were significantly different. The median initial pursuit acceleration was 22%, steady-state pursuit gain 16%, proportion smooth 7%, and target speed responsiveness 31% lower, while catch-up saccade amplitude was 46% and fixation error 46% larger. Excluding the two patients with diagnosed mild toxicity, four oculometrics, all but fixation error and proportion smooth, remained significantly impaired compared to controls. Across our population of 12 patients (24 retinae), we found that pursuit latency, initial acceleration, steady-state gain, and fixation error were linearly related to retinal thickness even when age was accounted for, while standard measures of clinical function (Mean Deviation and Pattern Standard Deviation) were not., Discussion: Our data show that specific oculometrics are sensitive early biomarkers of functional deficits in SLE patients on HCQ that could be harnessed to assist in the early detection of HCQ-induced retinal toxicity and other visual pathologies, potentially providing early diagnostic value beyond standard visual field and OCT evaluations., Competing Interests: LS is listed as an inventor on National Aeronautics and Space Administration patents that cover some of the methods used in this paper but is not involved in any commercialization activities. Furthermore, none of NASA’s commercial licensees had any involvement in this study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 United States Government as represented by the Administrator of the National Aeronautics and Space Administration and Mr. Berneshawi, Dr. Goel, Mr. Anderson, Dr. Akay, Dr. Akay, and Dr. Leung. At least a portion of this work is authored by Ms. Seyedmadani, Mr. Tyson and Dr. Stone on behalf of the U.S government and, as regards Ms. Seyedmadani, Mr. Tyson and Dr. Stone, U.S. copyright protection does not attach to separable portions of a Work authored solely by U.S. Government employees as part of their official duties. The U.S. Government is the owner of foreign copyrights in such separable portions of the Work and is a joint owner (with any non-U.S. Government author) of U.S. and foreign copyrights that may be asserted in inseparable portions the Work. The U.S. Government retains the right to use, reproduce, distribute, create derivative works, perform, and display portions of the Work authored solely or co-authored by a U.S. Government employee. Non-U. S copyrights also apply.)
- Published
- 2024
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