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Long-term fluctuation of relative afferent pupillary defect in subjects with normal visual function
A Kawasaki1, P Moore, R H Kardon
1Midwest Eye Institute, Methodist Hospitals of Indiana, Indianapolis 46280, USA.
American Journal of Ophthalmology
|December 1, 1996
Summary
In normal individuals, a small relative afferent pupillary defect (RAPD) can persist over time without indicating disease. This finding suggests that isolated RAPDs within a certain range may be considered benign.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
- Optometry
Background:
- The relative afferent pupillary defect (RAPD) is a clinical sign indicating differential optic nerve or retinal function.
- Understanding the natural history and variability of RAPD in healthy individuals is crucial for accurate diagnosis.
Purpose of the Study:
- To investigate the long-term stability of the relative afferent pupillary defect (RAPD) in subjects with normal ocular health.
- To assess whether RAPD measurements remain consistent over a multi-year period in a healthy cohort.
Main Methods:
- Seventeen healthy participants underwent infrared pupillography and automated perimetry across four testing sessions spanning three years.
- Evaluated changes in RAPD magnitude and visual field asymmetry between serial examinations.
Main Results:
- The range of RAPD observed was 0.0 to 0.3 log units, with visual field asymmetry between 0 to 3 dB.
- Eight participants consistently exhibited RAPD in the same eye.
- Changes in RAPD magnitude between sessions were generally small, with a median change of 0.08 log units.
Conclusions:
- A small, persistent relative afferent pupillary defect (RAPD) can be present in normal individuals without underlying pathology.
- An isolated RAPD up to 0.3 log units, lacking other clinical indicators, is likely benign and does not warrant further investigation.