The pupil in dominant optic atrophy

PURPOSE. To compare visual and pupil afferent function in dominant optic at rophy (DOA). METHODs. Patients with DOA who belonged to families showing evidence of lin kage to the locus on chromosome 3q28-qter were recruited from the Moorfield s Genetic Register. Patients and healthy control subjects underwent visual and pupil perimetry using a modified automated perimeter (Octopus 1-2-3; In terzeag, Schlieren, Switzerland). Five stimulus locations were tested: fixa tion, and at 17 degrees eccentricity along the 45 degrees and 135 degrees m eridians in all four quadrants. The visual deficit (difference in decibels between the patient's luminance threshold and that in age-matched healthy c ontrol subjects) was compared directly with the pupil deficit (difference i n decibels between the stimulus intensity giving the patient's pupil respon se and that giving an equivalent pupil response in healthy control subjects ) at each test location. ,Ys. Pupil function appears less affected than vis ual function at four of five locations tested. This result provides evidenc e that the retinotectal fibers serving the pupil light reflex are less susc eptible to damage from the OPA1 genetic defect than the retinogeniculate fi bers serving vision. CONCLUSIONS. Pupil function appears less affected than visual function at f our of five locations tested. This result provides evidence that the retino tectal fibers serving the pupil light reflex are less susceptible to damage from the OPA1 genetic defect than the retinogeniculate fibers serving visi on.