Novel ERG for Detection of Hydroxychloroquine Retinopathy

NCT ID: NCT06035887

Last Updated: 2025-08-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

140 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-05-31

Study Completion Date

2026-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of the study is to investigate novel electroretinography (ERG) devices in the detection of hydroxychloroquine retinopathy. Two devices (the RETEval full-field and flicker ERG and UTAS multifocal ERG) will be evaluated in this study, comparing device outputs to standard of care screening tests, in groups of participants characterised by presence or absence of hydroxychloroquine-related retinopathy.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Hydroxychloroquine (HCQ) is a widely used drug used to treat disorders of inflammation in the body with up to 320,000 people estimated to be on this drug in the UK alone. Retinopathy due to HCQ is a significant problem, necessitating yearly screening which can only realistically take place in hospital eye units where funding and capacity constraints limit the provision of services.

Electroretinography is a non-invasive method of testing for eye retinal problems, which works by flashing light (in certain patterns and brightness) into eyes and measuring the electrical response through fine wires placed on the eye surface or behind the eyelid, and is considered by many authors to be a gold-standard test to detect HCQ retinopathy. Their use has been limited due to the high expertise required to undertake and interpret tests, limited availability of testing, and high test burden, however newer electroretinography devices have been developed by a company called LKC Technologies, which are faster to perform, use leads placed on the skin (rather than the eye surface) which are more comfortable, easier to use by healthcare technicians, and can be done without the need for dilating eyedrops. The two devices being tested in this study are:

* The RETEval = a handheld electroretinography testing device
* The UTAS multifocal ERG = a trolley-mounted electroretinography testing device

These innovations may make testing far easier to develop in both hospital eye service, and potentially even general settings such as outpatient clinics, general practices, and optometrists. This study aims to evaluate the performance of devices to detect and classify participants in 4 main groups:

* Normative control participants (n=35)
* Patients taking HCQ but without retinopathy (n=35)
* Patients taking HCQ with indeterminate features of retinopathy (also known as POSSIBLE retinopathy) (n=35)
* Patients taking HCQ with definite retinopathy

Device outputs will be analysed and compared with masked graded screening results (incorporating spectral-domain macular optical coherence tomography and autofluorescence as standard, taken on the same visit) to generate device- and device-output-specific sensitivities and specificities. If a signal is found, the feasibility outcomes from this study will inform the study methodology and timelines for a larger trial if necessary.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hydroxychloroquine Retinopathy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Normative Controls

Age- and sex- matched normal controls

Hand-Held Full-Field Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

RETEval Complete hand-held electroretinogram

Trolley-Mounted Multifocal Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

UTAS multifocal electroretinogram

Spectral-Domain Optical Coherence Tomography (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Spectral-Domain Optical Coherence Tomography (macular structural scan)

Macular Autofluorescence (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Autofluorescence imaging (macular structural image)

On Hydroxychloroquine, NO retinopathy

Participants over 18 years on hydroxychloroquine without hydroxychloroquine-related retinopathy

Hand-Held Full-Field Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

RETEval Complete hand-held electroretinogram

Trolley-Mounted Multifocal Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

UTAS multifocal electroretinogram

Spectral-Domain Optical Coherence Tomography (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Spectral-Domain Optical Coherence Tomography (macular structural scan)

Macular Autofluorescence (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Autofluorescence imaging (macular structural image)

On Hydroxychloroquine, POSSIBLE retinopathy

Participants over 18 years on hydroxychloroquine with possible (indeterminate) hydroxychloroquine-related retinopathy

Hand-Held Full-Field Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

RETEval Complete hand-held electroretinogram

Trolley-Mounted Multifocal Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

UTAS multifocal electroretinogram

Spectral-Domain Optical Coherence Tomography (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Spectral-Domain Optical Coherence Tomography (macular structural scan)

Macular Autofluorescence (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Autofluorescence imaging (macular structural image)

On Hydroxychloroquine, DEFINITE retinopathy

Participants over 18 years on hydroxychloroquine with definite hydroxychloroquine-related retinopathy

Hand-Held Full-Field Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

RETEval Complete hand-held electroretinogram

Trolley-Mounted Multifocal Skin-Electrode Electroretinography (Device to be evaluated)

Intervention Type DIAGNOSTIC_TEST

UTAS multifocal electroretinogram

Spectral-Domain Optical Coherence Tomography (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Spectral-Domain Optical Coherence Tomography (macular structural scan)

Macular Autofluorescence (Standard of Care test)

Intervention Type DIAGNOSTIC_TEST

Heidelberg Engineering Spectralis Autofluorescence imaging (macular structural image)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Hand-Held Full-Field Skin-Electrode Electroretinography (Device to be evaluated)

RETEval Complete hand-held electroretinogram

Intervention Type DIAGNOSTIC_TEST

Trolley-Mounted Multifocal Skin-Electrode Electroretinography (Device to be evaluated)

UTAS multifocal electroretinogram

Intervention Type DIAGNOSTIC_TEST

Spectral-Domain Optical Coherence Tomography (Standard of Care test)

Heidelberg Engineering Spectralis Spectral-Domain Optical Coherence Tomography (macular structural scan)

Intervention Type DIAGNOSTIC_TEST

Macular Autofluorescence (Standard of Care test)

Heidelberg Engineering Spectralis Autofluorescence imaging (macular structural image)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age ≥18 years
2. HCQ groups:

a. HCQ use \>5 years for patients without any high-risk factors, or \>1 year in patients with one or more high-risk factors for HCQ retinopathy, namely: i. Dose \>5mg/kg per day actual body weight (ABW) ii. Estimated glomerular filtration rate (eGFR) of \<60mls/min/1.73m2 iii. Concomitant tamoxifen use
3. Control group:

1. No prior HCQ exposure

Exclusion Criteria

1. Cataract grade ≥3 of any subtype
2. Recent cataract surgery within 4 weeks of recruitment
3. Significant media opacity or corneal disease including, but not limited to, corneal oedema, corneal scarring, keratoconus, previous corneal transplants, severe keratoconjunctivitis sicca (requiring the use of topical serum, immunosuppressive or analogous therapy, or procedural treatment).
4. Significant macular co-pathology including, but not limited to, macular degeneration, macular scarring, cystic macular oedema (for any reason), staphyloma.
5. Inherited retinal and/or macular dystrophies including colour vision deficiencies
6. Active or previous posterior uveitis or pan-uveitis
7. Aphakia
8. High refractive error \>6.00 dioptres
9. Amblyopia
10. Diabetes
11. Retinal angiopathies including, but no limited to, retinal vein occlusion, retinal artery occlusion, ocular ischaemic syndrome, HIV retinopathy, Sickle cell disease, radiation retinopathy
12. Visually significant surgical retinal disease including epiretinal membrane, macular hole, retinal detachment, retinal tear
13. Previous retinal laser or intravitreal treatment
14. Moderate or worse glaucoma
15. Optic atrophy
16. Photosensitive epilepsy
17. Ungradable HCQ retinopathy screening images
18. Periocular infection or rash (recruitment can be deferred until acute pathology has resolved)
19. Unable or unwilling to undertake study activities
20. Any active use or history of the following medications:

Amiodarone Canthaxanthin Deferoxamine Digoxin Ethambutol Interferon-alpha Melatonin Nefazodone Sildenafil Vigabatrin Chloroquine Quinine
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

LUPUS UK

UNKNOWN

Sponsor Role collaborator

King's College Hospital Charity

UNKNOWN

Sponsor Role collaborator

King's College Hospital NHS Trust

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Professor Timothy L Jackson

Role: STUDY_CHAIR

King's College Hospital NHS Trust

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

King's College Hospital

London, London, United Kingdom

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Dr Chan Ning Lee

Role: CONTACT

020 3299 1297

Ophthalmology research inbox

Role: CONTACT

020 3299 1297

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Dr Chan Ning Lee

Role: primary

Ophthalmology research inbox

Role: backup

References

Explore related publications, articles, or registry entries linked to this study.

Lee CN, Wafa HA, Murphy G, Galloway J, Mahroo OA, Jackson TL. Novel electroretinography devices to detect hydroxychloroquine retinopathy: study protocol for a diagnostic accuracy and feasibility study. BMJ Open Ophthalmol. 2024 Dec 24;9(1):e001898. doi: 10.1136/bmjophth-2024-001898.

Reference Type DERIVED
PMID: 39719323 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

IRAS 317611

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

RetinaVue Diabetic Screening
NCT03343730 UNKNOWN NA
Peripheral Retina Robotically Aligned OCT Study
NCT06451068 NOT_YET_RECRUITING NA