A New Visual Field for Hydroxychloroquine Screening

Well, why don't we get started? You know, in your editorial, you suggest that many retina specialists may not have been aware that these combined field paradigms existed, uh, as they were originally marketed primarily to glaucoma specialists.

So specifically, why was the Kim et al paper the right kinda catalyst to finally bring the 24-2C into the retina world and something we should be considering for, you know, plaquenil screening?

This was a very good article, and Kim not only pointed out that this test is here and people can get it easily, but they, he showed that it works for hydroxychloroquine retinopathy.

He provided the validation, and he published in a retina journal.

Uh, retina specialists don't read the glaucoma literature, but they do read the retinal literature.

That makes a lot of sense.

[chuckles] Now, you noted that performing separate 10-2 and 24-2 or 30-2 fields is, as you said, rather impractical, yet both are necessary for effective screening.

You know, based on the findings, uh, in the Kim study that you editorialized, how does the 24-2C eliminate this burden without, uh, reducing screening sensitivity?

The 24-2C test basically adds central points to the standard 24-2.

It doesn't quite fill up the entire center, but it fills up enough that it was adequate for screening, uh, central or parafoveal patterns of retinopathy, as well as the more peripheral pattern, uh, pericentral, which is actually rather, rather more common in an Asian population.

In the past, to get enough central points to recognize parafoveal retinopathy, you really had to do a 10-2 field.

But fields take time to do, they're costly, patients get tired.

Trying to do two fields on the same patient in an exam is very hard to do, and doing two separate fields means coming back for two visits.

So this really opened up the option of doing this combined test, which in fact takes less time than a 10-2 field by itself.

Well, and then so going into it, you know, one of the takeaways from your editorial is that the 24-2C is comparable in sensitivity to both 10-2 and 30-2.

And given about the 94.7% sensitivity reported for the parafoveal disease, does this study provide the evidence we need to adopt a single field 24-2C strategy for screening?

I think it does.