More sensitive correlation of afferent pupillary defect with ganglion cell complex / Correlación más sensible entre el defecto pupilar aferente y el complejo de células ganglionares

Purpose: This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. Methods: RAPD 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. Results: Eighteen 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 0.6 log 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%). Conclusions: Significant 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 0.3 log unit increment was approximately 8.49 m. The FLV% corresponded more sensitively to a RAPD but appeared to be influenced by disease severity

Objetivo: Este estudio investigó la correlación entre el defecto pupilar aferente relativo (DPAR) y el grosor de la capa de fibras nerviosas de la retina (RNFLT) en la neuropatía óptica. Métodos: La valoración del DPAR se realizó utilizando una barra de filtro de densidad neutra de unidades logarítmicas. Para examinar a los sujetos se utilizó tomografía de coherencia óptica de dominio espectral RTVue-100 (Optovue). A los fines del estudio, se subdividió e identificó el patrón de la cabeza del nervio óptico (ONH) en RNFLT circumpapilar (cpRNFLT) y RNFLT circumpapilar periférico (pcpRNFLT). Se analizaron los parámetros de cpRNFLT, pcpRNFLT y del complejo de células ganglionares (GCC). Resultados: Se incluyó en el estudio a dieciocho mujeres y treinta y tres varones con neuropatía óptica asimétrica y DPAR. Treinta y tres sujetos tenían glaucoma y ocho neuropatía óptica diferente a glaucoma. Se obtuvieron correlaciones significativas (p < 0,02) para DPAR y pérdida de diferencia porcentual de los parámetros GCC y RNFLT. La pérdida de diferencia porcentual media agrupada para RNFLT fue considerablemente diferente a la de GCC (p < 0,001). Para una unidad log de 0,6 de DPAR, la pérdida de diferencia porcentual media fue del 23% para CRNFLT, del 15% para GCC, del 12% para el porcentaje de volumen de pérdida global, y del 6% para el porcentaje de pérdida focal de volumen (FLV%). Conclusiones: Se observaron correlaciones significativas entre la pérdida de RNFLT para los parámetros cpRNFLT, pcpRNFLT y GCC con DPAR. Se obtuvo aproximadamente un 35% de mayor sensibilidad utilizando los parámetros GCC en comparación a CRNFL. El cambio previsto en la media de GCC para cada incremento de unidad log de 0,3 fue de aproximadamente 8,49 um. El FLV% se correspondió de manera más sensible con DPAR, pero pareció verse influenciado por la severidad de la enfermedad

More sensitive correlation of afferent pupillary defect with ganglion cell complex.

PURPOSE: This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. METHODS: RAPD 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. RESULTS: Eighteen 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%). CONCLUSIONS: Significant 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.