June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Relationship Between Relative Afferent Pupillary Defect with Pupillography and Ganglion Cell Complex Thickness by Optical Coherence Tomography in Asymmetric Glaucoma
Author Affiliations & Notes
  • Naoki Ozeki
    Keio University, Tokyo, Japan
  • Kenya Yuki
    Keio University, Tokyo, Japan
  • Daisuke Shiba
    Keio University, Tokyo, Japan
  • Kazuo Tsubota
    Keio University, Tokyo, Japan
  • Footnotes
    Commercial Relationships Naoki Ozeki, Konan Medical USA (F); Kenya Yuki, None; Daisuke Shiba, Konan Medical USA (F); Kazuo Tsubota, AcuFocus, Inc (C), Allergan (F), Bausch Lomb Surgical (C), Functional visual acuity meter (P), JiNS (P), Kissei (F), Kowa (F), Santen, Inc. (F), Otsuka (F), Pfizer (C), Thea (C), Echo Denki (P), Nidek (F), Ophtecs (F), Wakasa Seikatsu (F), CEPT Company (P)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1893. doi:
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      Naoki Ozeki, Kenya Yuki, Daisuke Shiba, Kazuo Tsubota; Relationship Between Relative Afferent Pupillary Defect with Pupillography and Ganglion Cell Complex Thickness by Optical Coherence Tomography in Asymmetric Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1893.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate association between the magnitude of relative afferent pupillary defect (RAPD) with pupillography and macular ganglion cell complex thickness (MGCCT) in asymmetric glaucoma.

Methods: We used RAPDx (Konan Medical USA, USA) to evaluate RAPD. The RAPDx is designed to analyze pupil response at multiple, controlled stimulus intensities and multiple color stimuli (white, red, green, blue and yellow). This device records precise amplitude and latency of pupil responses. Inclusion criteria were having optic disc abnormalities and visual field loss with glaucoma. Patients with having retinal disease, optic neuropathy, cornea disease, non-reactive pupils and asymmetric cataract were excluded. MGCCT was measured with spectral domain optical coherence tomography (RS-3000; Nidek, Japan). We evaluated association between asymmetry of the macular MGCCT and RAPDx amplitude and latency of multiple color stimuli (white, red, green, blue and yellow).

Results: Fifty six glaucoma patients (34 males, 22 females; mean age: 62.6 ± 12.0 years; range: 28 - 88 years) were enrolled. Mean MGCCT were 88.9 ± 12.2 (range: 56 - 112) μm in thicker eyes and 76.3 ± 12.5 (range: 53 - 103) μm in thinner eyes. The differences of MGCCT (thicker eye - thinner eye) were 12.7 ± 10.8 (range: 1 - 40) μm. The log-scaled RAPD amplitude were as follows; white 0.37±0.47, red 0.26±0.78, green 0.33±0.54, blue 0.40±0.62, yellow 0.35±0.56. The results of linear regression analysis between the log-scaled RAPD amplitude and the MGCCT asymmetry were as follows; white R2 = 0.44 (p<0.001), red R2 = 0.29 (p<0.001), green R2 = 0.27 (p<0.001), blue R2 = 0.24 (p<0.001), yellow R2 = 0.25 (p<0.001). The log-scaled RAPD latency were as follows; white 0.09±0.23, red -0.01±0.38, green 0.12±0.39, blue 0.07±0.54, yellow -0.04±0.21. The results of linear regression analysis between the log-scaled RAPD latency and the MGCCT asymmetry were as follows; white R2 = 0.07 (p = 0.04), red R2 = 0.001 (p = 0.76), green R2 = 0.04 (p = 0.15), blue R2 = 0.05 (p = 0.08), yellow R2 = 0.02 (p = 0.25).

Conclusions: Log-scaled RAPD amplitude had moderate correlation to MGCCT asymmetry, however RAPD latency had weaker relationship to MGCCT asymmetry. White stimulus had stronger relationship to MGCCT asymmetry than other colored stimuli.

Keywords: 668 pupillary reflex • 531 ganglion cells • 629 optic nerve  
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