More Sensitive Correlation of Afferent Pupillary Defect with Ganglion Cell Complex

Overview

Journal J Optom

Specialty Ophthalmology

Date 2017 Jul 6

PMID 28676353

Citations 4

Authors

Eulogio Besada

Barry J Frauens

Rim Makhlouf

Diana Shechtman

Julie Rodman

Marlon Demeritt

Patrick Hardigan

Affiliations

Soon will be listed here.

Abstract

Purpose: This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy.

Methods: RAPD assessment was performed using a log unit neutral density filter bar. Spectral domain optical coherence tomography RTVue-100 (Optovue) was used to examine the subjects. The optic nerve head pattern (ONH) was subdivided and identified for the purpose of the study into circumpapillary RNFLT (cpRNFLT) and peripheral circumpapillary RNFLT (pcpRNFLT). The cpRNFLT, pcpRNFLT and ganglion cell complex (GCC) parameters were analyzed.

Results: Eighteen females and twenty three males with asymmetric optic neuropathy and a RAPD participated. Thirty-three subjects had glaucoma and eight had optic neuropathy other than glaucoma. Significant correlations (p<0.02) were obtained for the RAPD and the percentage difference loss of the GCC and RNFLT parameters. The grouped mean percentage difference loss for RNFLT was significantly different from that of the GCC (p<0.001). At a 0.6log unit RAPD, the average mean percentage difference loss was 23% for the CRNFLT, 15% for the GCC, 12% for the global loss volume percentage and 6% for the focal loss volume percentage (FLV%).

Conclusions: Significant correlations between RNFLT loss for cpRNFLT, pcpRNFLT and GCC parameters with RAPD were observed. Approximately a 35% higher sensitivity was obtained using GCC compared to CRNFL parameters. The expected change in GCC average for every 0.3log unit increment was approximately 8.49μm. The FLV% corresponded more sensitively to a RAPD but appeared to be influenced by disease severity.

Citing Articles

Detection of Relative Afferent Pupillary Defect and Its Correlation with Structural and Functional Asymmetry in Patients with Glaucoma Using Hitomiru, a Novel Hand-Held Pupillometer.

Nakamura M, Sakamoto M, Ueda K, Okuda M, Takano F, Yamada-Nakanishi Y J Clin Med. 2023; 12(12).

PMID: 37373631 PMC: 10299646. DOI: 10.3390/jcm12123936.

Retinal nerve fiber layer and ganglion cell complex thickness analysis in patients having relative afferent pupillary defect.

Mishra A, Ashraf M, Zaka-Ur-Rab S, Khan N Indian J Ophthalmol. 2022; 70(12):4337-4342.

PMID: 36453341 PMC: 9940509. DOI: 10.4103/ijo.IJO_754_22.

Macular imaging with optical coherence tomography in glaucoma.

Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee J, Sharifipour F, Daneshvar R Surv Ophthalmol. 2020; 65(6):597-638.

PMID: 32199939 PMC: 7423773. DOI: 10.1016/j.survophthal.2020.03.002.

A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA).

Meneguette N, de Carvalho J, Petzold A J Neurol. 2019; 266(4):969-974.

PMID: 30746557 DOI: 10.1007/s00415-019-09223-1.

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