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J.Y. Chuo, R.J. Prosser, N.K. Wade; Correlation between RAPD and subjective bright light desaturation . Invest. Ophthalmol. Vis. Sci. 2004;45(13):240.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the correlation between physician–reported relative afferent papillary defect (RAPD) and patient–reported subjective bright light desaturation. Methods: Data was collected on all patient visits with a recorded RAPD by a neuro–ophthalmologist during the years of 1999 to 2002. Patient information including demographics, etiology leading to RAPD assessment, severity of RAPD as measured by the physician–reported "plus" grading scale, and patient–reported subjective bright light desaturation (SBLD) was recorded. Results: 475 separate RAPD assessments performed were recorded on 426 patients, 171 (40.1%) of whom were male and 255 (59.9%) female. 292 (61.2%) assessments were performed on females and 185 (38.8%) on males. The mean age was 48.0 years. A correlation of 0.717* was found between RAPD plus scale and SBLD. Correlation in females and males were 0.686* and 0.768*, respectively. Correlation in patients <20 years old (n = 20) was 0.602*; 20 – 39 years old (n = 139) 0.661*; 40 – 59 years old (n = 189) 0.720*; and ≥60 years old (n = 106) 0.784*. Correlation between RAPD plus scale and SBLD was found to be similar in patients across all subgroups of diagnoses, ranging from 0.899* in strokes and TIAs and 0.597* in compressive CNS lesions. Patients with a RAPD plus grading of 0 reported a median and mean SBLD of 0% and 12.4%, respectively; patients with a RAPD of 0.5+ reported a median and mean SBLD of 20% and 24.4%; RAPD of 1+ corresponded to a median and mean SBLD of 30% and 33.4%; RAPD of 2+ corresponded to a median and mean SBLD of 50% and 52.1%; RAPD of 3+ corresponded to a median and mean SBLD of 80% and 75.9%; and RAPD of 4+ corresponded to a median and mean SBLD of 90% and 86.3%. *p = .000 Conclusions: A relatively high correlation was found between physician–reported RAPD plus grading and SBLD in this study population. The correlation was found to be similar between males and females and across all subgroups of diagnoses, and increases with the age of the patient. Although not ideal, patient–reported SBLD can thus be used to estimate the degree of RAPD in situations where a physician–reported RAPD grading cannot be obtained (e.g. when the patient has had cycloplegics).
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