Clinical evaluation of a rapid, pupil-based assessment of retinal damage associated with glaucoma

Abstract

Nicholas Wride1, Majed Habib1, Keith Morris2, Steve Campbell3, Scott Fraser11Sunderland Eye Infirmary, City Hospitals Sunderland NHS Foundation Trust, Sunderland, Tyne and Wear, UK; 2Applied Neurodiagnostics Ltd, Cramlington, Northumberland, UK; 3School of Health, University of New England, New South Wales, AustraliaAims: To evaluate the effectiveness of a new test, the Pupilmetrix™ PLR60, which uses the pupillary light reflex (PLR) to detect asymmetric retinal damage in patients diagnosed with glaucoma.Methods: 30 patients, clinically diagnosed as having glaucoma, were recruited to the study, 29 of whom completed testing using the PLR60. A control group of 30 patients who had glaucoma excluded by clinical examination were also recruited and tested using the same protocol on the PLR60.Results: Of the 110 eyes with test outcomes, overall agreement between the PLR60 result and clinical diagnosis (glaucoma positive or negative) per eye was 84.7%. Sensitivity was 93.1% (95% CI 77.2%–99.2%) and specificity was 76.7% (95% CI 57.7%–90.1%). Average (SD) test times (min:sec) for both eyes were 3:21 (0:33) minutes for the glaucoma group and 2:40 (0:35) minutes for the non-glaucoma group.Conclusions: The results of this preliminary study suggest that the PLR as used in the Pupilmetrix™ PLR60 test is able to discriminate between patients with glaucomatous retinal defects and those with clinically normal retinas with a diagnostic accuracy that is potentially useful for screening for glaucoma. Test times were markedly quicker than with standard visual field testing.Keywords: glaucoma, pupillary light reflex, retina, Pupilmetrix