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Stefania Bianchi Marzoli, Gemma Tremolada, Anna Merico, Gabriella Cammmarata, Paola Ciasca; Correlation of Relative Afferent Pupillary Defect (RAPD) pupillograph measurements with optic nerve function and structure in optic neuropathies. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4112.
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© ARVO (1962-2015); The Authors (2016-present)
To correlate the pupils response amplitude obtained by Konan RAPDx high definition pupillograph with visual loss and SD-OCT measurements in acute and chronic non-glaucomatous optic neuropathies
Consecutive patients presenting to the Neuro-ophthalmology Service with diagnosis of acute or chronic, unilateral or bilateral, non-glaucomatous optic neuropathies underwent full clinical examination to measure the Best Corrected Visual Acuity (BCVA, decimal), Humphrey automated perimetry (SITA standard 30-2) to obtained Mean Deviation (MD, dB), SD-OCT analysis (RTVue-Optovue) to estimate Macular Ganglion Cell Complex Thickness (MGCCT, μm). White stimulus RAPDx pupillograph (Konan Medical USA) was performed to assess Log-scaled RAPD amplitudes. Patients with having retinal disease, cornea disease, irregular or fixed pupils and asymmetric cataract were excluded. Linear regression analysis was applied to compare Log-scaled RAPD amplitudes with differences (best eye-worst eye) of BCVA, MD and MGCCT values.
127 patients (44 males, 83 females; mean age: 46.28 ± 18.06 years; range: 11 - 80 years) were enrolled. Mean BCVA difference was 0.3 ± 0.4 (range: 0-1.0) decimal, mean MD difference was 6.21 ± 7.5 (range: 0-32.4) dB, and mean MGCCT difference was 9.35 ± 9.72 (range: 0.01 - 35) µm. Log-scaled RAPD amplitude was 1.3 ± 2.74 (range: 17.18 - 0,010) The results of linear regression analysis were statistically significant between the log- scaled RAPD amplitude and BCVA differences (p<0.001, R2 =0.2), MD differences (p<0.001 R2 =0.3) and MGCCT differences (p=0.0105, R2 = 0.05).
RAPDx pupillography amplitudes were moderately correlated to BCVA and MD differences indicating a good relationship with functional asymmetry parameters in an etherogeneous group of non-glaucomatous optic neuropathies including bilateral cases. A poor relationship found between RAPD measurements and MGCCT differences could be related to the different degree of optic nerve impairment in a series including acute cases in which the degree of atrophy may not yet have developed. RAPDx high definition pupillograph can be a quantitative tool to assess asymmetric optic nerve impairement.
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