A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA)

Autor: Axel Petzold, Nathalie Stéphanie Meneguette, J. Emanuel Ramos de Carvalho
Přispěvatelé: APH - Methodology, APH - Mental Health, Amsterdam Neuroscience - Neuroinfection & -inflammation, Ophthalmology
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
genetic structures
Diagnostic Techniques
Ophthalmological
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Optical coherence tomography
Pupil Disorders
Ophthalmology
Afferent Pupillary Defect
Optic Nerve Diseases
medicine
Humans
Optic neuritis
030212 general & internal medicine
skin and connective tissue diseases
Retrospective Studies
Anisocoria
medicine.diagnostic_test
Reflex
Abnormal
business.industry
Area under the curve
Retinal
Middle Aged
medicine.disease
bacterial infections and mycoses
RAPD
Ganglion
respiratory tract diseases
medicine.anatomical_structure
Neurology
chemistry
ROC Curve
Area Under Curve
Female
Neurology (clinical)
sense organs
medicine.symptom
business
030217 neurology & neurosurgery
Tomography
Optical Coherence
Zdroj: Meneguette, N S, de Carvalho, J E R & Petzold, A 2019, ' A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA) ', Journal of Neurology, vol. 266, no. 4, pp. 969-974 . https://doi.org/10.1007/s00415-019-09223-1
Journal of Neurology, 266(4), 969-974. D. Steinkopff-Verlag
ISSN: 1432-1459
0340-5354
Popis: Background: Detection of a relative afferent pupillary defect (RAPD) by the swinging-light test can be challenging in clinical practice (dark eyes, anisocoria, dark environment). We developed a new method of RAPD quantification based on the recording of the infrared pupillary asymmetry (IPA) with a standard optical coherence tomography (OCT) device. Methods: The diagnostic value of the IPA for detection of the RAPD was determined by receiver-operating characteristic (ROC) curves and area under the curve (AUC). Results: Twenty-nine subjects were included in this study (17 controls and 12 unilateral optic neuropathies). The IPA was significantly greater in unilateral optic neuropathies (0.39) compared to controls (0.18, p = 0.001). The diagnostic value was good with a ROC–AUC of 0.843. Importantly, the IPA correlated significantly with the inter-eye percentage difference of the macular ganglion cell-inner plexiform layer (mGCIPL) thickness (R = 0.53, p = 0.01). Assessment of the IPA took less than 30 s. Conclusion: The present data show that the IPA is a practical and rapid test that can be applied in a clinical setting. The IPA may be a valuable functional outcome measure for clinical trials, complementing structural retinal OCT data in a biological meaningful way. The IPA should be further investigated for suitability for optic neuritis treatment trials.
Databáze: OpenAIRE
Externí odkaz: