TY - JOUR T1 - More sensitive correlation of afferent pupillary defect with ganglion cell complex JO - Journal of Optometry T2 - AU - Besada,Eulogio AU - Frauens,Barry J. AU - Makhlouf,Rim AU - Shechtman,Diana AU - Rodman,Julie AU - Demeritt,Marlon AU - Hardigan,Patrick SN - 18884296 M3 - 10.1016/j.optom.2017.02.004 DO - 10.1016/j.optom.2017.02.004 UR - https://www.journalofoptometry.org/en-more-sensitive-correlation-afferent-pupillary-articulo-S1888429617300390 AB - PurposeThis study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. MethodsRAPD 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. ResultsEighteen 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%). ConclusionsSignificant 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. ER -