Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion
Purpose To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization. Methods Retrospective analysis of the TROXHEMO trial that included patients with CRVO...
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| Veröffentlicht in: | Acta ophthalmologica (Oxford, England) England), 2021-03, Vol.99 (2), p.215-220 |
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| creator | Ducloyer, Jean‐Baptiste Bensaber, Sonia Khanna, Raoul Kanav Cochard, Catherine Lebreton, Olivier Le Meur, Guylène Lebranchu, Pierre Arsene, Sophie Weber, Michel |
| description | Purpose
To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization.
Methods
Retrospective analysis of the TROXHEMO trial that included patients with CRVO within 30 days after the onset. Inclusion criteria were as follows: semi‐quantitative RAPD assessment at diagnosis and/or at one month. RAPD was ‘severe’ if ≥ 0.9 log. Exclusion criteria were as follows: prophylactic panretinal photocoagulation (PRP) before neovascularization.
Results
Among the 119 patients enrolled in the main centre, 101 were analysed. 26 had a neovascular complication during the twelve months of follow‐up: rubeosis (19), glaucoma (7) and posterior neovascularization (15). The mean time to onset of a neovascular complication was 4.7 months (1 to 12, median 3 months). All the patients who had a neovascular complication had RAPD at first examination or at one month (negative predictive value (NPV) = 100%) but the positive predictive value (PPV) was low (31%, 95% CI [21%; 42%]). The association ‘severe RAPD or VA |
| doi_str_mv | 10.1111/aos.14544 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_proquest_miscellaneous_2426537141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2498859099</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4224-8ba010112ebb64bf7c5e58abeff9568ccb546e7e24f83371f9cde744a4d1247e3</originalsourceid><addsrcrecordid>eNp1kcFu1DAQhiMEoqVw4AVQJC5w2NZ2bMc5riqgSCsVCZC4WY4zFq6ceGsnqdpTH4Ezj8eTMOkui4SEL2P9-jz_jP-ieEnJKcVzZmI-pVxw_qg4prUQq6qW6vHhLr4dFc9yviJEUin50-KoYjWhjKjj4uenBJ23o5-hnE2YIJfRlX7wozehzND7X_c_riczjH40D5TJGXLuYRgXMkHYy85BWsTttPUhmHRbduDAjqWLqRwgzibbCXV_hw_igB6lRT6hTYLRD1hnQDFaG6aMxPPiiTMhw4t9PSm-vn_35fxitbn88PF8vVlZzhhfqdYQSihl0LaSt662AoQyLTjXCKmsbQWXUAPjTlVVTV1jO6g5N7yjjNdQnRRvd32_m6C3yfc4u47G64v1Ri8aqaQgVKqZIvtmx25TvMbPGnXvswXcFzecsmacSYEmfEFf_4NexSnhmgvVKCUa0jR_zW2KOSdwhwko0Uu4GsPVD-Ei-2rfcWp76A7knzQRONsBNz7A7f876fXl513L3wJ2sqs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2498859099</pqid></control><display><type>article</type><title>Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion</title><source>Wiley Free Content</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Ducloyer, Jean‐Baptiste ; Bensaber, Sonia ; Khanna, Raoul Kanav ; Cochard, Catherine ; Lebreton, Olivier ; Le Meur, Guylène ; Lebranchu, Pierre ; Arsene, Sophie ; Weber, Michel</creator><creatorcontrib>Ducloyer, Jean‐Baptiste ; Bensaber, Sonia ; Khanna, Raoul Kanav ; Cochard, Catherine ; Lebreton, Olivier ; Le Meur, Guylène ; Lebranchu, Pierre ; Arsene, Sophie ; Weber, Michel</creatorcontrib><description>Purpose
To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization.
Methods
Retrospective analysis of the TROXHEMO trial that included patients with CRVO within 30 days after the onset. Inclusion criteria were as follows: semi‐quantitative RAPD assessment at diagnosis and/or at one month. RAPD was ‘severe’ if ≥ 0.9 log. Exclusion criteria were as follows: prophylactic panretinal photocoagulation (PRP) before neovascularization.
Results
Among the 119 patients enrolled in the main centre, 101 were analysed. 26 had a neovascular complication during the twelve months of follow‐up: rubeosis (19), glaucoma (7) and posterior neovascularization (15). The mean time to onset of a neovascular complication was 4.7 months (1 to 12, median 3 months). All the patients who had a neovascular complication had RAPD at first examination or at one month (negative predictive value (NPV) = 100%) but the positive predictive value (PPV) was low (31%, 95% CI [21%; 42%]). The association ‘severe RAPD or VA < 35 letters (ETDRS) at inclusion or at one month’ was the best compromise between PPV (53%, [39%; 68%]) and NPV (96%, [92%; 100%]).
Conclusion
To predict neovascularization, RAPD should be routinely evaluated with filters: the risk of neovascular complication is (a) almost nil if there is no RAPD, (b) very low if there is no severe RAPD and if VA is higher than 35 letters, and (c) higher than 50% if RAPD is ≥ 0.9 log or if VA is less than 35 letters.</description><identifier>ISSN: 1755-375X</identifier><identifier>ISSN: 1395-3931</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.14544</identifier><identifier>PMID: 32701208</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acuity ; afferent pupillary defect ; central retinal vein occlusion ; Glaucoma ; Human health and pathology ; ischaemic central retinal vein occlusion ; Life Sciences ; neovascular glaucoma ; neovascularization ; Occlusion ; predictive value ; Retina ; rubeosis ; Sensory neurons ; Sensory Organs ; Vascularization</subject><ispartof>Acta ophthalmologica (Oxford, England), 2021-03, Vol.99 (2), p.215-220</ispartof><rights>2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd</rights><rights>2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 Acta Ophthalmologica Scandinavica Foundation</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4224-8ba010112ebb64bf7c5e58abeff9568ccb546e7e24f83371f9cde744a4d1247e3</citedby><cites>FETCH-LOGICAL-c4224-8ba010112ebb64bf7c5e58abeff9568ccb546e7e24f83371f9cde744a4d1247e3</cites><orcidid>0000-0002-1306-1908 ; 0000-0001-6032-1488</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faos.14544$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faos.14544$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32701208$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03650168$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ducloyer, Jean‐Baptiste</creatorcontrib><creatorcontrib>Bensaber, Sonia</creatorcontrib><creatorcontrib>Khanna, Raoul Kanav</creatorcontrib><creatorcontrib>Cochard, Catherine</creatorcontrib><creatorcontrib>Lebreton, Olivier</creatorcontrib><creatorcontrib>Le Meur, Guylène</creatorcontrib><creatorcontrib>Lebranchu, Pierre</creatorcontrib><creatorcontrib>Arsene, Sophie</creatorcontrib><creatorcontrib>Weber, Michel</creatorcontrib><title>Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion</title><title>Acta ophthalmologica (Oxford, England)</title><addtitle>Acta Ophthalmol</addtitle><description>Purpose
To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization.
Methods
Retrospective analysis of the TROXHEMO trial that included patients with CRVO within 30 days after the onset. Inclusion criteria were as follows: semi‐quantitative RAPD assessment at diagnosis and/or at one month. RAPD was ‘severe’ if ≥ 0.9 log. Exclusion criteria were as follows: prophylactic panretinal photocoagulation (PRP) before neovascularization.
Results
Among the 119 patients enrolled in the main centre, 101 were analysed. 26 had a neovascular complication during the twelve months of follow‐up: rubeosis (19), glaucoma (7) and posterior neovascularization (15). The mean time to onset of a neovascular complication was 4.7 months (1 to 12, median 3 months). All the patients who had a neovascular complication had RAPD at first examination or at one month (negative predictive value (NPV) = 100%) but the positive predictive value (PPV) was low (31%, 95% CI [21%; 42%]). The association ‘severe RAPD or VA < 35 letters (ETDRS) at inclusion or at one month’ was the best compromise between PPV (53%, [39%; 68%]) and NPV (96%, [92%; 100%]).
Conclusion
To predict neovascularization, RAPD should be routinely evaluated with filters: the risk of neovascular complication is (a) almost nil if there is no RAPD, (b) very low if there is no severe RAPD and if VA is higher than 35 letters, and (c) higher than 50% if RAPD is ≥ 0.9 log or if VA is less than 35 letters.</description><subject>Acuity</subject><subject>afferent pupillary defect</subject><subject>central retinal vein occlusion</subject><subject>Glaucoma</subject><subject>Human health and pathology</subject><subject>ischaemic central retinal vein occlusion</subject><subject>Life Sciences</subject><subject>neovascular glaucoma</subject><subject>neovascularization</subject><subject>Occlusion</subject><subject>predictive value</subject><subject>Retina</subject><subject>rubeosis</subject><subject>Sensory neurons</subject><subject>Sensory Organs</subject><subject>Vascularization</subject><issn>1755-375X</issn><issn>1395-3931</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kcFu1DAQhiMEoqVw4AVQJC5w2NZ2bMc5riqgSCsVCZC4WY4zFq6ceGsnqdpTH4Ezj8eTMOkui4SEL2P9-jz_jP-ieEnJKcVzZmI-pVxw_qg4prUQq6qW6vHhLr4dFc9yviJEUin50-KoYjWhjKjj4uenBJ23o5-hnE2YIJfRlX7wozehzND7X_c_riczjH40D5TJGXLuYRgXMkHYy85BWsTttPUhmHRbduDAjqWLqRwgzibbCXV_hw_igB6lRT6hTYLRD1hnQDFaG6aMxPPiiTMhw4t9PSm-vn_35fxitbn88PF8vVlZzhhfqdYQSihl0LaSt662AoQyLTjXCKmsbQWXUAPjTlVVTV1jO6g5N7yjjNdQnRRvd32_m6C3yfc4u47G64v1Ri8aqaQgVKqZIvtmx25TvMbPGnXvswXcFzecsmacSYEmfEFf_4NexSnhmgvVKCUa0jR_zW2KOSdwhwko0Uu4GsPVD-Ei-2rfcWp76A7knzQRONsBNz7A7f876fXl513L3wJ2sqs</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Ducloyer, Jean‐Baptiste</creator><creator>Bensaber, Sonia</creator><creator>Khanna, Raoul Kanav</creator><creator>Cochard, Catherine</creator><creator>Lebreton, Olivier</creator><creator>Le Meur, Guylène</creator><creator>Lebranchu, Pierre</creator><creator>Arsene, Sophie</creator><creator>Weber, Michel</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-1306-1908</orcidid><orcidid>https://orcid.org/0000-0001-6032-1488</orcidid></search><sort><creationdate>202103</creationdate><title>Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion</title><author>Ducloyer, Jean‐Baptiste ; Bensaber, Sonia ; Khanna, Raoul Kanav ; Cochard, Catherine ; Lebreton, Olivier ; Le Meur, Guylène ; Lebranchu, Pierre ; Arsene, Sophie ; Weber, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4224-8ba010112ebb64bf7c5e58abeff9568ccb546e7e24f83371f9cde744a4d1247e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acuity</topic><topic>afferent pupillary defect</topic><topic>central retinal vein occlusion</topic><topic>Glaucoma</topic><topic>Human health and pathology</topic><topic>ischaemic central retinal vein occlusion</topic><topic>Life Sciences</topic><topic>neovascular glaucoma</topic><topic>neovascularization</topic><topic>Occlusion</topic><topic>predictive value</topic><topic>Retina</topic><topic>rubeosis</topic><topic>Sensory neurons</topic><topic>Sensory Organs</topic><topic>Vascularization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ducloyer, Jean‐Baptiste</creatorcontrib><creatorcontrib>Bensaber, Sonia</creatorcontrib><creatorcontrib>Khanna, Raoul Kanav</creatorcontrib><creatorcontrib>Cochard, Catherine</creatorcontrib><creatorcontrib>Lebreton, Olivier</creatorcontrib><creatorcontrib>Le Meur, Guylène</creatorcontrib><creatorcontrib>Lebranchu, Pierre</creatorcontrib><creatorcontrib>Arsene, Sophie</creatorcontrib><creatorcontrib>Weber, Michel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ducloyer, Jean‐Baptiste</au><au>Bensaber, Sonia</au><au>Khanna, Raoul Kanav</au><au>Cochard, Catherine</au><au>Lebreton, Olivier</au><au>Le Meur, Guylène</au><au>Lebranchu, Pierre</au><au>Arsene, Sophie</au><au>Weber, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2021-03</date><risdate>2021</risdate><volume>99</volume><issue>2</issue><spage>215</spage><epage>220</epage><pages>215-220</pages><issn>1755-375X</issn><issn>1395-3931</issn><eissn>1755-3768</eissn><abstract>Purpose
To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization.
Methods
Retrospective analysis of the TROXHEMO trial that included patients with CRVO within 30 days after the onset. Inclusion criteria were as follows: semi‐quantitative RAPD assessment at diagnosis and/or at one month. RAPD was ‘severe’ if ≥ 0.9 log. Exclusion criteria were as follows: prophylactic panretinal photocoagulation (PRP) before neovascularization.
Results
Among the 119 patients enrolled in the main centre, 101 were analysed. 26 had a neovascular complication during the twelve months of follow‐up: rubeosis (19), glaucoma (7) and posterior neovascularization (15). The mean time to onset of a neovascular complication was 4.7 months (1 to 12, median 3 months). All the patients who had a neovascular complication had RAPD at first examination or at one month (negative predictive value (NPV) = 100%) but the positive predictive value (PPV) was low (31%, 95% CI [21%; 42%]). The association ‘severe RAPD or VA < 35 letters (ETDRS) at inclusion or at one month’ was the best compromise between PPV (53%, [39%; 68%]) and NPV (96%, [92%; 100%]).
Conclusion
To predict neovascularization, RAPD should be routinely evaluated with filters: the risk of neovascular complication is (a) almost nil if there is no RAPD, (b) very low if there is no severe RAPD and if VA is higher than 35 letters, and (c) higher than 50% if RAPD is ≥ 0.9 log or if VA is less than 35 letters.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32701208</pmid><doi>10.1111/aos.14544</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1306-1908</orcidid><orcidid>https://orcid.org/0000-0001-6032-1488</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acuity afferent pupillary defect central retinal vein occlusion Glaucoma Human health and pathology ischaemic central retinal vein occlusion Life Sciences neovascular glaucoma neovascularization Occlusion predictive value Retina rubeosis Sensory neurons Sensory Organs Vascularization |
| title | Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion |
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