Relative afferent pupillary defect in patient with Leber hereditary optic neuropathy and unilateral viual lo Original Reearch Article

PURPOE: It ha been uggeted that the pupillary light reaction i relatively preerved in the affected eye of patient with Leber hereditary optic neuropathy (LHON). To tet the hypothei that viual-pupillomotor diociation exit in LHON, we performed a retropective tudy to evaluate the magnitude of the relative afferent pupillary defect (RAPD) in patient who had experienced monocular viual lo. We alo compared the ize of the meaured RAPD with the ize of the RAPD that would be expected on the bai of documented viual field lo. METHOD: We identified a cohort of patient with LHON and monocular viual lo, whoe pupillary reaction had been quantified uing neutral denity filter. From a review of the cae record, we determined whether an RAPD wa preent, a well a the magnitude of the documented RAPD. We alo calculated the expected ize of the RAPD for each patient, uing previouly etablihed template that correlated the ize of the RAPD with the degree of viual field lo. REULT: An RAPD wa identified in all 10 patient in thi tudy. There wa no ignificant difference between the ize of the meaured and predicted RAPD, nor did the ize of the RAPD correlate with viual acuity or the time interval between the onet of viual lo and evaluation. CONCLUION: The reult of thi tudy do not upport the hypothei that viual-pupillomotor diociation i a common feature of LHON.