Background: Detection of a relative afferent pupillary defect (RAPD) by the swinging-light test can be challenging in clinical practice (dark eyes, anisocoria). We developed a new method of RAPD quantification based on the recording of the Infrared Pupillary Asymmetry (IPA) with a standard optical coherence tomography (OCT) device. Methods:The diagnostic value of the IPA for detection of the RAPD was determined by Receiver Operating Characteristic (ROC) curves, Area Under the Curve (AUC).Results: Twenty-nine subjects were included in this study (17 controls, 12 unilateral optic neuropathies). The IPA was significantly greater in unilateral optic neuropathies (0.39) compared to controls (0.18, p = 0.001). The diagnostic value was good with a ROC-AUC of 0.843. Importantly, the IPA correlated significantly with the inter-eye difference of the macular ganglion cell-inner plexiform layer (mGCIPL) thickness (R = 0.53, p = 0.01). Assessment of the IPA took less than 30 seconds. Conclusion:Present data show that the IPA is a practical and rapid test that can be applied in a clinical setting. The IPA may be a valuable functional outcome measure for clinical trials, complementing structural retinal OCT data in a biological meaningful way. The IPA should be further investigated for suitability for optic neuritis treatment trials.

No abstract

No abstract

No abstract