Titre : | Effect of Light Intensity on the Relative Afferent Pupillary Defect in Unilateral Neuro-ophthalmic Pathology |
Type de document : | article de périodique |
Auteurs : | Negi Rahul ; Raviselvan Munispriyan ; Yarravarapu Divyank ; Chillakala Koteswararao ; Reena MOptom ; Baskar Juhi ; Jain Ashish ; Karan BDes ; Bhate Manjushree ; Shrikant Bharadwaj |
Année de publication : | 2023 |
Langues : | Français (fre) |
Descripteurs (mots clés) : | [Thésaurus Mesh]Collecte de données [Thésaurus Mesh]Lumière [Thésaurus Mesh]Réflexe pupillaire [Thésaurus Mesh]Troubles pupillaires [Thésaurus HELB]:Paramédical:Pupillométrie
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Mots-clés : | pupillométrie objective intensités lumineuses défaut pupillaire pathologie neuro-ophtalmique unilatérale |
Résumé : | SIGNIFICANCE: Objective pupillometry with standardized light intensities allows a comprehensive assessment of the relative afferent pupillary defect in patients with unilateral neuro-ophthalmic pathology. PURPOSE: This study aimed to determine the impact of varying light intensities on the grade of relative afferent pupillary defect in unilateral neuro-ophthalmic pathology vis-à -vis healthy controls. METHODS: Monocular pupillary light reflexes of 20 controls (14 to 50 years) and 31 cases (12 to 72 years) with clinically diagnosed relative afferent pupillary defect were measured thrice using 1-second-long light pulses, followed by 3 seconds of darkness, at eight light intensities (6.4 to 1200 lux) using objective pupillometry. The relative afferent pupillary defect was quantified as the ratio of the percentage change in the direct light reflexes of the left and right eyes. Its change with light intensity was described using standard exponential fits. RESULTS: The median (25th to 75th interquartile range) defect score of 54.8% cases decreased from baseline values of 1.58 (1.25 to 1.87) for right eye pathology and 0.45 (0.39 to 0.55) for left eye pathology to saturation values of 1.18 (1.05 to 1.31) and 0.98 (0.95 to 1.06), respectively, at light intensities between 56.9 and 300.5 lux. Like controls (1.01 [1.00 to 1.06]), the defect scores of the remaining 45.2% cases were constant with light intensity at 1.23 (1.18 to 1.46) and 0.87 (0.86 to 0.89) for right and left eye pathologies, respectively. CONCLUSIONS:Relative afferent pupillary defects may decrease with test light intensity in a significant proportion of patients with unilateral neuro-ophthalmic pathology. This highlights the importance of objective pupillometry with standardization light intensities for clinical assessment of afferent pupillary defects. |
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