Relative Afferent Pupillary Defects in Homonymous Visual Field Defects Caused by Stroke of the Occipital Lobe Using Pupillometer

Figures & data

Table 1. Detailed profile and results of patients with HVFDs.

Patient no	Age (years)	Sex	HVFD Side	Duration* (months)	RV (logMAR)	LV (logMAR)	RAPD score
							Amplitude	Latency
1	38	F	R	18	−0.18	−0.18	0.06	0.03
2	52	F	L	48	0.05	0.00	−0.63	−0.07
3	52	M	R	1	−0.18	−0.18	0.03	0.1
4	55	F	L	4	0.05	0.10	−0.17	−0.09
5	65	M	L	1	−0.08	0.10	−0.52	−0.12
6	66	M	L	22	−0.08	−0.18	0.08	−0.18
7	66	M	R	0	−0.18	−0.18	0.06	0.04
8	69	F	L	31	−0.08	−0.08	−0.01	−0.28
9	70	F	L	48	0.00	0.00	−0.09	−0.16
10	70	F	L	2	−0.18	−0.18	−0.25	−0.03
11	72	F	R	19	0.15	0.10	0.4	0.2
12	73	F	R	1	0.30	0.15	−0.22	−0.06
13	74	M	L	60	0.00	−0.08	−0.06	−0.2
14	75	F	L	0	0.30	0.10	−0.05	0.07
15	79	M	R	1	−0.08	0.00	−0.14	0.01

HVFD = homonymous visual field defect; RV = right eye visual acuity; LV = left eye visual acuity; RAPD = relative afferent pupillary defect

* Interval of time between the stroke and examination

Table 2. The clinical characteristics of the 15 patients with HVFDs.

Lesion side(patients)	Right; 6, Left; 9
Age, years, mean ± SD (range)	65.1 ± 11.1 (from 38 to 79)
Female, n (%)	9 (60.0)
Interval of time between the stroke and examination, mean month ± SD (range)	17.0 ± 20.7 (from 0 to 60.0)
Spherical equivalent refractive error, mean diopters ± SD (range)
Right eye	−0.90 ± 2.74 (from −8.75 to +2.50)
Left eye	−0.47 ± 2.30 (from −7.25 to +2.50)
Visual acuity, mean logMAR ± SD (range)
Right eye	−0.01 ± 0.16 (from 0.30 to −0.18)
Left eye	−0.03 ± 0.13 (from 0.15 to −0.18)
RAPD score*
Amplitude, mean ± SD (range)	0.13 ± 0.24 (from −0.22 to 0.63)
Latency, mean ± SD (range)	0.09 ± 0.10 (from −0.07 to 0.28)

HVFD = homonymous visual field defect; RAPD = relative afferent pupillary defects; SD = standard deviation.

*Positive RAPD scores indicate RAPD present in the right eye. The sign of the scores from the patients with left HVFDs was inverted.

Figure 1. Box plot of the relative afferent pupillary defect (RAPD) scores in the patients with homonymous visual field defects (HVFD) and control groups. Upper horizontal line of box = mean plus one standard deviation (SD); Lower horizontal line of box = mean minus one SD; horizontal bar within box = mean; Upper horizontal bar outside box = maximum; Lower horizontal bar outside box = minimum. Circle = each measured value. RAPD scores of amplitude of the HVFDs (the sign of scores of the patients with left HVFDs were inverted to merge the data, n = 15) group were significantly higher in the eye contralateral to the brain lesion than those in the control group (n = 32) (p < 0.05). Also, the RAPD scores of latency were significantly higher in the eye contralateral to the brain lesion than those of the controls (p < 0.01). * p < 0.05, ** p < 0.01.

Figure 2. The relationship between the RAPD scores and the interval of time from the stroke to examination of RAPD.

The upper scatter plot shows the relationship between the RAPD score of amplitude (the sign of scores of the patients with left HVFDs was inverted to merge them with those of the right HVFDs, n = 15) and interval of time from the stroke to examination. R = 0.21 (p = 0.45). The lower scatter plot shows the relationship between the RAPD score of latency (the sign of scores of the patients with left HVFDs was inverted to merge them with those of the right HVFDs, n = 15) and interval of time from the stroke to examination. R = 0.59 (p = 0.02).