A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA)
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 s...
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| Veröffentlicht in: | Journal of neurology 2019-04, Vol.266 (4), p.969-974 |
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| creator | Meneguette, Nathalie Stéphanie de Carvalho, J. Emanuel Ramos Petzold, Axel |
| description | 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. |
| doi_str_mv | 10.1007/s00415-019-09223-1 |
| format | Article |
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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.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-019-09223-1</identifier><identifier>PMID: 30746557</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Asymmetry ; Cameras ; Clinical trials ; Light ; Medicine ; Medicine & Public Health ; Neuritis ; Neurology ; Neuroradiology ; Neurosciences ; Optic neuritis ; Optics ; Original Communication ; Physiology ; Retina ; Sensory neurons</subject><ispartof>Journal of neurology, 2019-04, Vol.266 (4), p.969-974</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Journal of Neurology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3341-3bf4283a6692072f97acec25f8a7d3251e31d9e0d6c87d8207a6cfc9cd3414193</citedby><cites>FETCH-LOGICAL-c3341-3bf4283a6692072f97acec25f8a7d3251e31d9e0d6c87d8207a6cfc9cd3414193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-019-09223-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-019-09223-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30746557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meneguette, Nathalie Stéphanie</creatorcontrib><creatorcontrib>de Carvalho, J. Emanuel Ramos</creatorcontrib><creatorcontrib>Petzold, Axel</creatorcontrib><title>A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA)</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>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.</description><subject>Asymmetry</subject><subject>Cameras</subject><subject>Clinical trials</subject><subject>Light</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuritis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Optic neuritis</subject><subject>Optics</subject><subject>Original Communication</subject><subject>Physiology</subject><subject>Retina</subject><subject>Sensory neurons</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kctu1DAUhq0K1A6FF-iissRmugg9vsVJd6Nyq1SJqoK15TrHJdUkmdoOUle8Cs_Ck3HKDBexYGXL__efi3_GjgS8EgD2NANoYSoQbQWtlKoSe2whtJKV0KZ9whagNFRGGX3AnuV8BwANCfvsQIHVtTF2wb6uuILv3zIvmAuPU-L3sx9LX3zpvyD3OWPOA46FT5F7nnC9E2LE9Pi8mTf9eu3TA-8wYih8eb26en1yxstn5P0Yk0_Y_UX5_DAMWOi2vLhanTxnT6NfZ3yxOw_Zp7dvPp6_ry4_vLs4X11WQSktKnUTtWyUr-tWgpWxtT5gkCY23nZKGoFKdC1CV4fGdg0xvg4xtKEjtxatOmTLbd1Nmu5n2tUNfQ5IM404zdlJYmoQpqkJffkPejfNaaTpiLL0g8YKIEpuqZCmnBNGt0n9QBs6Ae4xHreNx1E87mc8TpDpeFd6vhmw-235lQcBagtkksZbTH96_6fsDz6HmkE</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Meneguette, Nathalie Stéphanie</creator><creator>de Carvalho, J. Emanuel Ramos</creator><creator>Petzold, Axel</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201904</creationdate><title>A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA)</title><author>Meneguette, Nathalie Stéphanie ; de Carvalho, J. Emanuel Ramos ; Petzold, Axel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3341-3bf4283a6692072f97acec25f8a7d3251e31d9e0d6c87d8207a6cfc9cd3414193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Asymmetry</topic><topic>Cameras</topic><topic>Clinical trials</topic><topic>Light</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuritis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Optic neuritis</topic><topic>Optics</topic><topic>Original Communication</topic><topic>Physiology</topic><topic>Retina</topic><topic>Sensory neurons</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meneguette, Nathalie Stéphanie</creatorcontrib><creatorcontrib>de Carvalho, J. Emanuel Ramos</creatorcontrib><creatorcontrib>Petzold, Axel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meneguette, Nathalie Stéphanie</au><au>de Carvalho, J. Emanuel Ramos</au><au>Petzold, Axel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA)</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2019-04</date><risdate>2019</risdate><volume>266</volume><issue>4</issue><spage>969</spage><epage>974</epage><pages>969-974</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30746557</pmid><doi>10.1007/s00415-019-09223-1</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Asymmetry Cameras Clinical trials Light Medicine Medicine & Public Health Neuritis Neurology Neuroradiology Neurosciences Optic neuritis Optics Original Communication Physiology Retina Sensory neurons |
| title | A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA) |
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