Besada Eulogio, Frauens Barry J, Makhlouf Rim, Shechtman Diana, Rodman Julie, Demeritt Marlon, Hardigan Patrick
Nova Southeastern University College of Optometry, United States.
Nova Southeastern University College of Optometry, United States.
J Optom. 2018 Apr-Jun;11(2):75-85. doi: 10.1016/j.optom.2017.02.004. Epub 2017 Jul 1.
This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy.
RAPD assessment was performed using a log unit neutral density filter bar. Spectral domain optical coherence tomography RTVue-100 (Optovue) was used to examine the subjects. The optic nerve head pattern (ONH) was subdivided and identified for the purpose of the study into circumpapillary RNFLT (cpRNFLT) and peripheral circumpapillary RNFLT (pcpRNFLT). The cpRNFLT, pcpRNFLT and ganglion cell complex (GCC) parameters were analyzed.
Eighteen females and twenty three males with asymmetric optic neuropathy and a RAPD participated. Thirty-three subjects had glaucoma and eight had optic neuropathy other than glaucoma. Significant correlations (p<0.02) were obtained for the RAPD and the percentage difference loss of the GCC and RNFLT parameters. The grouped mean percentage difference loss for RNFLT was significantly different from that of the GCC (p<0.001). At a 0.6log unit RAPD, the average mean percentage difference loss was 23% for the CRNFLT, 15% for the GCC, 12% for the global loss volume percentage and 6% for the focal loss volume percentage (FLV%).
Significant correlations between RNFLT loss for cpRNFLT, pcpRNFLT and GCC parameters with RAPD were observed. Approximately a 35% higher sensitivity was obtained using GCC compared to CRNFL parameters. The expected change in GCC average for every 0.3log unit increment was approximately 8.49μm. The FLV% corresponded more sensitively to a RAPD but appeared to be influenced by disease severity.
本研究调查了视神经病变中相对传入性瞳孔障碍（RAPD）与视网膜神经纤维层厚度（RNFLT）之间的相关性。
使用对数单位中性密度滤光条进行RAPD评估。采用光谱域光学相干断层扫描RTVue - 100（Optovue）对受试者进行检查。为该研究目的，将视神经乳头模式（ONH）细分为视盘周围视网膜神经纤维层厚度（cpRNFLT）和周边视盘周围视网膜神经纤维层厚度（pcpRNFLT）。分析cpRNFLT、pcpRNFLT和神经节细胞复合体（GCC）参数。
18名女性和23名男性患有不对称性视神经病变且存在RAPD，参与了研究。33名受试者患有青光眼，8名患有除青光眼以外的视神经病变。RAPD与GCC及RNFLT参数的百分比差异损失之间存在显著相关性（p<0.02）。RNFLT的分组平均百分比差异损失与GCC的分组平均百分比差异损失显著不同（p<0.001）。在0.6对数单位RAPD时，CRNFLT的平均平均百分比差异损失为23%，GCC为15%，总体损失体积百分比为12%，局灶性损失体积百分比（FLV%）为6%。
观察到cpRNFLT、pcpRNFLT的RNFLT损失及GCC参数与RAPD之间存在显著相关性。与CRNFL参数相比，使用GCC获得的敏感性约高35%。每增加0.3对数单位，GCC平均值的预期变化约为8.49μm。FLV%与RAPD的对应更敏感，但似乎受疾病严重程度影响。
