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Published on: February 15, 2022
[Relative afferent pupillary defect in glaucoma]
Karolina Skorkovská1, H Wilhelm, H Lüdtke
1Augenklinik, Universitätsklinikum Tübingen. skorka@centrum.cz
Klinische Monatsblatter Fur Augenheilkunde
|August 18, 2011
Summary
Relative afferent pupillary defect (RAPD) is present in about one-third of primary open-angle glaucoma patients, particularly those with advanced visual field loss and asymmetry. The swinging-flashlight test is recommended for glaucoma diagnosis.
Area of Science:
- Ophthalmology
- Neuroscience
Context:
- Glaucoma diagnosis relies on visual field testing and optic nerve assessment.
- Relative afferent pupillary defect (RAPD) is a potential indicator of optic nerve dysfunction in glaucoma.
- The relationship between RAPD and glaucoma severity/asymmetry requires further elucidation.
Purpose:
- To determine the frequency of RAPD in primary open-angle glaucoma (POAG).
- To investigate the correlation between RAPD and the severity of visual field defects.
- To assess the association between RAPD and visual field asymmetry in POAG patients.
Summary:
- A retrospective study included 100 POAG patients; 34% exhibited RAPD.
- Visual field analysis of 85 patients revealed significantly more advanced visual field loss (p < 0.01) and greater inter-eye asymmetry (p < 0.01) in those with RAPD.
- Visual field asymmetry demonstrated good predictive value for RAPD (AUC = 0.81).
Impact:
- RAPD is a common finding in approximately one-third of POAG cases.
- The presence of RAPD correlates with more severe and asymmetric visual field defects.
- Routine inclusion of the swinging-flashlight test in glaucoma diagnostics is advised to aid in identifying patients with significant visual field impairment.
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