Evaluation of the Glaucomatous Macular Damage by Chromatic Pupillometry
Ophthalmology and therapy(2023)
摘要
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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关键词
Chromatic pupillometry,Primary open-angle glaucoma,Macular structure
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