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Relative afferent pupillary defect in eyes with retinal detachment
J C Folk1, H S Thompson, S G Farmer
1Department of Ophthalmology, University of Iowa Hospitals, Iowa City 52242.
Ophthalmic Surgery
|October 1, 1987
Summary
Successful scleral buckling surgery significantly reduced relative afferent pupillary defects in patients with rhegmatogenous retinal detachment. Post-surgery, most patients showed improved or absent pupillary defects, indicating better optic nerve function.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Neuro-ophthalmology
Background:
- Unilateral rhegmatogenous retinal detachment can impair optic nerve function.
- Relative afferent pupillary defect (RAPD) is a clinical sign of optic nerve dysfunction.
Purpose of the Study:
- To evaluate the impact of scleral buckling surgery on RAPD in patients with unilateral rhegmatogenous retinal detachment.
- To develop a predictive model for RAPD based on the extent of retinal detachment.
Main Methods:
- Measurement of RAPD in 38 patients pre- and post-scleral buckling surgery.
- Development of a regression model correlating RAPD with detached retinal quadrants and macular involvement.
Main Results:
- Preoperative mean RAPD was 1.4 +/- 0.7 log units, decreasing to 0.4 +/- 0.3 log units postoperatively.
- 36 of 38 patients showed reduced RAPD; 7 had no measurable defect post-surgery.
- A prediction model indicated each detached quadrant added 0.35 log units and macular detachment added 0.68 log units to RAPD.
Conclusions:
- Scleral buckling surgery effectively improves or resolves relative afferent pupillary defects in rhegmatogenous retinal detachment.
- The extent of retinal detachment, particularly macular involvement, correlates with the severity of RAPD.
- While a predictive model exists, RAPD provides only a rough estimate of detachment extent and vice versa due to a large standard error.