Ophthalmology and Therapy (Jun 2023)

Evaluation of the Glaucomatous Macular Damage by Chromatic Pupillometry

  • Yadan Quan,
  • Huiyu Duan,
  • Zongyi Zhan,
  • Yuening Shen,
  • Rui Lin,
  • Tingting Liu,
  • Ting Zhang,
  • Jihong Wu,
  • Jing Huang,
  • Guangtao Zhai,
  • Xuefei Song,
  • Yixiong Zhou,
  • Xinghuai Sun

DOI
https://doi.org/10.1007/s40123-023-00738-5
Journal volume & issue
Vol. 12, no. 4
pp. 2133 – 2156

Abstract

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Abstract Introduction This study aimed to examine the performance of binocular chromatic pupillometry for the objective and rapid detection of primary open-angle glaucoma (POAG), and to explore the association between pupillary light response (PLR) features and structural glaucomatous macular damage. Methods Forty-six patients (mean age 41.00 ± 13.03 years) with POAG and 23 healthy controls (mean age 42.00 ± 11.08 years) were enrolled. All participants underwent sequenced PLR tests of full-field, superior/inferior quadrant-field chromatic stimuli using a binocular head-mounted pupillometer. The constricting amplitude, velocity, and time to max constriction/dilation, and the post-illumination pupil response (PIPR) were analyzed. The inner retina thickness and volume measurements were determined by spectral domain optical coherence tomography. Results In the full-field stimulus experiment, time to pupil dilation was inversely correlated with perifoveal thickness (r = − 0.429, P < 0.001) and perifoveal volume (r = − 0.364, P < 0.001). Dilation time (AUC 0.833) showed good diagnostic performance, followed by the constriction amplitude (AUC 0.681) and PIPR (AUC 0.620). In the superior quadrant-field stimulus experiment, time of pupil dilation negatively correlated with inferior perifoveal thickness (r = − 0.451, P < 0.001) and inferior perifoveal volume (r = − 0.417, P < 0.001). The dilation time in response to the superior quadrant-field stimulus showed the best diagnostic performance (AUC 0.909). In the inferior quadrant-field stimulus experiment, time to pupil dilation (P < 0.001) correlated well with superior perifoveal thickness (r = − 0.299, P < 0.001) and superior perifoveal volume (r = − 0.304, P < 0.001). Conclusion The use of chromatic pupillometry offers a patient-friendly and objective approach to detect POAG, while the impairment of PLR features may serve as a potential indicator of structural macular damage.

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