May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Correlation of Relative Afferent Pupillary Defect (RAPD) With Retinal Nerve Fiber Layer Thickness (RNFLT) and Visual Functions in Optic Neuritis (ON)
Author Affiliations & Notes
  • H. Cheng
    College of Optometry, University of Houston, Houston, Texas
  • M. Laron
    College of Optometry, University of Houston, Houston, Texas
  • R. A. Tang
    College of Optometry, University of Houston, Houston, Texas
  • L. J. Frishman
    College of Optometry, University of Houston, Houston, Texas
  • B. Zhang
    College of Optometry, University of Houston, Houston, Texas
  • J. S. Schiffman
    Neuro-ophthalmology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
  • Footnotes
    Commercial Relationships  H. Cheng, None; M. Laron, None; R.A. Tang, None; L.J. Frishman, None; B. Zhang, None; J.S. Schiffman, None.
  • Footnotes
    Support  P30 EY07551, National MS Society pilot grant
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1182. doi:https://doi.org/
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      H. Cheng, M. Laron, R. A. Tang, L. J. Frishman, B. Zhang, J. S. Schiffman; Correlation of Relative Afferent Pupillary Defect (RAPD) With Retinal Nerve Fiber Layer Thickness (RNFLT) and Visual Functions in Optic Neuritis (ON). Invest. Ophthalmol. Vis. Sci. 2008;49(13):1182. doi: https://doi.org/.

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

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Abstract

Purpose: : To correlate RAPD with RNFLT, Humphery visual field (HVF) and multifocal visual evoked potential (mfVEP) measurements in patients with multiple sclerosis (MS) and ON.

Methods: : 28 MS patients (age 23-56, mean 40±9.6) with a history of ON in one (16 patients) or both eyes (12 patients) and at least 6 months recovery from the most recent ON attack were included. RAPD was quantified by performing the swing flashlight test with log-scaled neutral density filters placed over the less affected eye. The RNFLT was measured with ocular coherence tomography (OCT Stratus 3000: Fast RNFL protocol). On HVF, a mean unlogged deviation for each eye was calculated from the total deviation plot by dividing each location’s deviation value (dB) by 10 then unlogging it, which was then averaged across the 24-2 test locations. Monocular mfVEPs were recorded with a multi-channel technique using 60 sector pattern-reversal dartboard stimuli (VERIS). Data analysis used customized software to calculate the interocular response amplitude ratio and interocular latency differences at each sector.1,2 A median or mean value from 60 sectors was used to represent an individual’s overall interocular response amplitude ratios or latency differences.

Results: : RAPD ranged from 0 to 1.2 log units. Regression analysis revealed a good linear relationship between RAPD and interocular RNFLT ratios or differences (R2=0.73 and 0.68 respectively, p<0.0001 for both), interocular mean unlogged deviation differences (R2=0.68, p<0.0001), and the median interocular mfVEP response amplitude ratios (in log scale) (R2=0.66, p<0.0001). A weaker linear relationship was found between RAPD and 1) HVF interocular mean deviation (MD in dB) differences: R2=0.45 (p=0.0001); 2) mfVEP mean or median interocular latency differences: R2=0.24, p=0.01 for both.

Conclusions: : Persistent RAPD defects in ON were correlated with retinal nerve fiber loss and functional deficits measured by HVF and mfVEP response amplitudes.1. Hood & Greenstein 2003; 2. Hood et al. 2004.

Keywords: pupillary reflex • neuro-ophthalmology: optic nerve • electrophysiology: clinical 
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