Jeong-Min Hwang1, Cheol Kim, Ji-Young Kim. 1. Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea. jhm@snu.ac.kr
Abstract
PURPOSE: To prospectively investigate the incidence, associated factors, and prognostic significance of relative afferent pupillary defects (RAPDs) in eyes with less severe cataract than in contralateral eyes. SETTING: Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea. METHODS: Forty patients with asymmetric cataract and a differences of 3 or more lines of Snellen visual acuity between eyes had detailed ophthalmic examinations including visual acuity, slitlamp evaluation, a swinging flashlight test before and after cataract surgery, and color vision assessment. RESULTS: Twenty-three of 40 patients (58%) had an RAPD (mean extent 0.39 log unit +/- 0.17 [SD]) in the eye with less severe cataract. The RAPD resolved or switched to the other eye after cataract extraction. All 5 patients with a unilateral totally opaque lens had a contralateral RAPD, confirming the relationship between totally opaque cataracts and RAPDs. The difference in visual acuity between the 2 eyes did not differ between patients with RAPD and those without RAPD. There was no association between the presence of RAPD and postoperative visual acuity. CONCLUSIONS: More than half the patients with asymmetric cataract had an RAPD that resolved in the eye with less severe cataract after cataract extraction. All patients with a unilateral totally opaque lens had an RAPD. The presence of a preoperative RAPD was not related to postoperative visual acuity.
PURPOSE: To prospectively investigate the incidence, associated factors, and prognostic significance of relative afferent pupillary defects (RAPDs) in eyes with less severe cataract than in contralateral eyes. SETTING: Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea. METHODS: Forty patients with asymmetric cataract and a differences of 3 or more lines of Snellen visual acuity between eyes had detailed ophthalmic examinations including visual acuity, slitlamp evaluation, a swinging flashlight test before and after cataract surgery, and color vision assessment. RESULTS: Twenty-three of 40 patients (58%) had an RAPD (mean extent 0.39 log unit +/- 0.17 [SD]) in the eye with less severe cataract. The RAPD resolved or switched to the other eye after cataract extraction. All 5 patients with a unilateral totally opaque lens had a contralateral RAPD, confirming the relationship between totally opaque cataracts and RAPDs. The difference in visual acuity between the 2 eyes did not differ between patients with RAPD and those without RAPD. There was no association between the presence of RAPD and postoperative visual acuity. CONCLUSIONS: More than half the patients with asymmetric cataract had an RAPD that resolved in the eye with less severe cataract after cataract extraction. All patients with a unilateral totally opaque lens had an RAPD. The presence of a preoperative RAPD was not related to postoperative visual acuity.