The Clinical Value of Relative Afferent Pupillary Defect

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  • RAPDの臨床価値

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<p>　Recently, the development of fundus imaging modalities, such as optical coherence tomography（OCT）and magnetic resonance imaging, has increased the amount of information available for the diagnosis of optic nerve disease with poor findings on fundoscopy. However, the relative afferent pupillary defect（RAPD）is a useful finding for diagnosing optic nerve disease. The measurement of RAPD has been widely performed in clinical settings; however, it has been limited to the qualitative evaluation of the presence or absence of RAPD in the diagnosis of optic nerve disease. In recent years, pupillography, which can quantitatively evaluate RAPD, has been introduced in clinical settings. RAPD measured on pupillography correlates with the conventional RAPD measured using a neutral density（ND）filter and can be measured simply and objectively, with fewer errors among examiners and higher sensitivity. Therefore, pupillography is useful for evaluating RAPD for the diagnosis of optic nerve disease and for evaluating the progress of optic nerve disease and other diseases. In addition, RAPD in optic nerve disease and glaucoma correlates with the inner retinal layer thickness measured using OCT. Therefore, quantitative evaluation of RAPD is expected to be useful as a screening tool to detect changes in the retinal structure. However, RAPD scores on pupillography are calculated based on the difference in pupillary constriction between the affected and fellow eyes, and they differ from the scores obtained using the swinging flashlight test with the ND filter.</p>

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