Relative Afferent Pupillary Defect in Compressive Optic Neuropathy Due to Meningioma

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Identifier rAPD_in_compressive_optic_neuropathy_due_to_meningioma_NOVEL
Title Relative Afferent Pupillary Defect in Compressive Optic Neuropathy Due to Meningioma
Alternative Title Video 3.1 Clinical features of a unilateral optic neuropathy from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator Daniel R. Gold, DO
Affiliation (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject Optic Nerve Disease
Description 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 35-year-old woman with a compressive optic neuropathy OS due to a meningioma. She had normal acuity and color OD, with 20/40 acuity and dyschromatopsia OS. There was loss of visual field OS with a mainly temporal defect, and optic nerve pallor was apparent in this eye as well. The video shows the swinging flashlight test, where a left relative afferent pupillary defect (rAPD) is apparent - e.g., when the light is shone in the right eye there is pupillary constriction, but when the light is moved to the left eye, there is pupillary dilation. It's as if the patient is in a bright room OD (i.e., the pupil needs to constrict), but then when moving the light from the right to the left eye, it's as if the patient is moving into a darker room (i.e., the pupil needs to dilate). The light should be held for the same duration on each eye - if the light is held on one eye longer than the fellow eye, this may cause a false positive in a normal patient. Loss of acuity, field and color vision with optic nerve pallor and an rAPD is highly suggestive of an optic neuropathy, which turned out to be compressive in this case. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This video depicts the common features of an optic neuropathy, including relative afferent pupillary defect (rAPD), with ipsilateral pallor and loss of visual feld due to a compressive meningioma. https://collections.lib.utah.edu/ark:/87278/ s6m95jb6
Date 2020-04
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Dan Gold Collection: https://novel.utah.edu/Gold/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6m95jb6
Setname ehsl_novel_gold
ID 1539431
Reference URL https://collections.lib.utah.edu/ark:/87278/s6m95jb6
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