Gracitelli Carolina P B, Tatham Andrew J, Zangwill Linda M, Weinreb Robert N, Abe Ricardo Y, Diniz-Filho Alberto, Paranhos Augusto, Baig Saif, Medeiros Felipe A
Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States 2Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.
Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States 3Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, United Kingdom.
Invest Ophthalmol Vis Sci. 2016 Apr;57(4):1738-46. doi: 10.1167/iovs.15-18079.
We examined the relationship between relative afferent pupillary defects (RAPDs) and macular structural damage measured by macular thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in patients with glaucoma.
A cross-sectional study was done of 106 glaucoma patients and 85 healthy individuals from the Diagnostic Innovations in Glaucoma Study. All subjects underwent standard automated perimetry (SAP) and optic nerve and macular imaging using Cirrus Spectral Domain Optical Coherence Tomography (SDOCT). Glaucoma was defined as repeatable abnormal SAP or progressive glaucomatous changes on stereo photographs. Pupil responses were assessed using an automated pupillometer, which records the magnitude of RAPD (RAPD score), with additional RAPD scores recorded for each of a series of colored stimuli (blue, red, green, and yellow). The relationship between RAPD score and intereye differences (right minus left eye) in circumpapillary retinal nerve fiber layer (cpRNFL) thickness, mGCIPL, macular thickness, and SAP mean deviation (MD), was examined using linear regression.
There was fair correlation between RAPD score and asymmetric macular structural damage measured by intereye difference in mGCIPL thickness (R(2) = 0.285, P < 0.001). The relationship between RAPD score and intereye difference in macular thickness was weaker (R(2) = 0.167, P < 0.001). Intereye difference in cpRNFL thickness (R(2) = 0.350, P < 0.001) and SAP MD (R(2) = 0.594, P < 0.001) had stronger association with RAPD scores compared to intereye difference in mGCIPL and macular thickness.
Objective assessment of pupillary responses using a pupillometer was associated with asymmetric macular structural damage in patients with glaucoma.
我们研究了青光眼患者相对传入性瞳孔障碍（RAPD）与通过黄斑厚度和黄斑神经节细胞-内丛状层（mGCIPL）厚度测量的黄斑结构损伤之间的关系。
对青光眼研究诊断创新项目中的106例青光眼患者和85名健康个体进行了一项横断面研究。所有受试者均接受了标准自动视野检查（SAP）以及使用Cirrus光谱域光学相干断层扫描（SDOCT）进行的视神经和黄斑成像。青光眼定义为可重复的异常SAP或立体照片上的进行性青光眼性改变。使用自动瞳孔计评估瞳孔反应，该瞳孔计记录RAPD的大小（RAPD评分），并记录一系列彩色刺激（蓝色、红色、绿色和黄色）中每个刺激的额外RAPD评分。使用线性回归分析了RAPD评分与视乳头周围视网膜神经纤维层（cpRNFL）厚度、mGCIPL、黄斑厚度和SAP平均偏差（MD）的双眼差异（右眼减去左眼）之间的关系。
RAPD评分与通过mGCIPL厚度的双眼差异测量的不对称黄斑结构损伤之间存在中等程度的相关性（R(2)=0.285，P<0.001）。RAPD评分与黄斑厚度的双眼差异之间的关系较弱（R(2)=0.167，P<0.001）。与mGCIPL和黄斑厚度的双眼差异相比，cpRNFL厚度的双眼差异（R(2)=0.350，P<0.001）和SAP MD（R(2)=0.594，P<0.001）与RAPD评分的相关性更强。
使用瞳孔计对视瞳孔反应进行客观评估与青光眼患者的不对称黄斑结构损伤相关。
