MA-SFM is an efficient and successful method of detecting RAPD

Swinging flashlight test modified with magnification (MA-SFM) is an efficient way of detecting relative afferent papillary defect (RAPD), states an investigation in the Journal of Glaucoma.

Dr Parul Ichhpujani et al., Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India, performed a prospective, observational study of 101 consecutive patients. This study group consisted of 68 diagnosed glaucoma patients, 20 glaucoma suspects and 13 controls. All participants were screened for RAPD presence of absence. This was completed by using either the standard swinging flashlight method (S-SFM), MA-SFM or the ophthalmoscope swinging flashlight method.

Humphrey visual field mean deviation (MD) in each eye, intereye differences in MD, disc damage likelihood score (DDLS) and intereye differences in DDLS were all measured. Weighted κ scores were also recorded to ensure agreement between tests.

The most sensitive method for identifying RAPD is MA-SFM for both intereye differences in DDLS and MD. There was significant agreement between the tests for the MA-SFM method and moderate to significant agreement between the observers. The study suggests that using MA-SFM for detecting RAPD is a low-cost, simple and reproducible method.