Predictive value of the initial quantified relative afferent pupillary defect in 19 consecutive patients with traumatic optic neuropathy

Mark A Alford; Jeffrey A Nerad; Keith D Carter

doi:10.1097/00002341-200109000-00005

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Predictive value of the initial quantified relative afferent pupillary defect in 19 consecutive patients with traumatic optic neuropathy

Journal article

Peer reviewed

Predictive value of the initial quantified relative afferent pupillary defect in 19 consecutive patients with traumatic optic neuropathy

Mark A Alford, Jeffrey A Nerad and Keith D Carter

Ophthalmic plastic and reconstructive surgery, Vol.17(5), pp.323-327

09/2001

DOI: 10.1097/00002341-200109000-00005

PMID: 11642487

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Abstract

To study the predictive value of the initial quantified relative afferent pupillary defect (RAPD) in patients with indirect traumatic neuropathy as it relates to final visual outcome. The RAPD was measured and quantified by neutral density filters in patients with unilateral indirect traumatic neuropathy. All patients were treated with megadose methylprednisolone by of the protocol established by the Second National Acute Spinal Cord Injury Study. Patients were followed twice daily during treatment and then at 3-month intervals. Nineteen patients were enrolled over a 23-month period. Patients ranged in age from 12 to 78 years old; 18 of the 19 patients were male. No patient with an RAPD of 2.1 log units or greater had visual recovery to better than hand motion vision. The 7 patients with an initial RAPD of less than 2.1 log units showed improvement in their RAPD and were found to have vision of 20/30 or better during the follow-up period. In patients treated with megadose methylprednisolone with an initial RAPD of less than 2.1 log units, visual acuity improved to 20/30 or better; however, patients with an initial RAPD of 2.1 or greater showed little visual improvement. The initial quantified RAPD appears to have a predictive value related to final visual outcome.

Predictive Value of Tests

Pupil Disorders - drug therapy

Glucocorticoids - administration & dosage

Pupil Disorders - diagnosis

Pupil Disorders - etiology

Optic Nerve Injuries - etiology

Humans

Middle Aged

Male

Treatment Outcome

Optic Nerve Injuries - diagnosis

Visual Acuity

Adolescent

Adult

Female

Aged

Craniocerebral Trauma - complications

Child

Facial Injuries - complications

Diagnostic Techniques, Ophthalmological

Methylprednisolone - administration & dosage

Optic Nerve Injuries - drug therapy

Details

Title: Subtitle: Predictive value of the initial quantified relative afferent pupillary defect in 19 consecutive patients with traumatic optic neuropathy
Creators: Mark A Alford - Ophthalmology Associates, Fort Worth, Texas, USA
Jeffrey A Nerad
Keith D Carter
Resource Type: Journal article
Publication Details: Ophthalmic plastic and reconstructive surgery, Vol.17(5), pp.323-327
DOI: 10.1097/00002341-200109000-00005
PMID: 11642487
NLM abbreviation: Ophthalmic Plast Reconstr Surg
ISSN: 0740-9303
eISSN: 1537-2677
Publisher: United States
Language: English
Date published: 09/2001
Academic Unit: Otolaryngology; Ophthalmology and Visual Sciences
Record Identifier: 9983980002402771

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