Pupillometer-based objective chromatic perimetry in normal eyes and patients with retinal photoreceptor dystrophies.

Abstract

PURPOSE:

To evaluate a novel objective perimetry using multifocal chromatic pupil light reflex in normal participants and patients with photoreceptor dysfunction, and to relate this new technique with subjective dark-adapted chromatic Goldmann perimetry.

METHODS:

Thirty-two eyes of 17 retinitis pigmentosa (RP) or cone-rod dystrophy patients and 20 eyes of 12 healthy individuals were tested. A computerized infrared video pupillometer was used to record changes in pupil diameter in response to short- and long-wavelength stimuli (peak 485 and 640 nm, respectively; light intensity 40 cd/m(2)) at 13 different points of the 30° visual field (VF), under background illumination of 2.7 cd/m(2). The pupillary response (PR) of patients was compared with PR obtained from normal control participants. In 11 patients, the pupillary responses were also compared with their findings on dark-adapted chromatic Goldmann perimetry.

RESULTS:

Significantly reduced pupillary responses were obtained in RP patients in response to the short-wavelength stimulus in nearly all perimetric locations (P < 0.03). By contrast, in response to the long-wavelength stimulus, RP patients demonstrated significantly reduced PR mostly in peripheral locations (P ≤ 0.02). In a cone-rod dystrophy patient, the PR to both long- and short-wavelength stimuli was significantly lower in the scotoma area identified by the dark-adapted chromatic Goldmann perimetry. In all patients that were tested by the chromatic Goldmann, minimal PR was recorded in areas that were nondetected in the chromatic Goldmann perimetry.

CONCLUSIONS:

This study demonstrates the potential feasibility of using pupillometer-based chromatic perimetry for objectively assessing VF defects and retinal function in patients with retinal dystrophies. (ClinicalTrials.gov number, NCT01021982.).

• Authors: Alon Skaat, Ifat Sher, Andrew Kolker, Sivan Elyasiv, Elkana Rosenfeld, Mohamad Mhajna, Shlomo Melamed, Michael Belkin, Ygal Rotenstreich
• Journal: Investigative ophthalmology & visual science (Invest Ophthalmol Vis Sci) Vol. 54 Issue 4 Pg. 2761-70 (Apr 17 2013) ISSN: 1552-5783 [Electronic] United States
• PMID: 23482470 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Dark Adaptation
• Female
• Humans
• Light
• Male
• Middle Aged
• Photic Stimulation
• Photoreceptor Cells, Vertebrate (physiology)
• Pupil (physiology)
• Reflex, Pupillary (radiation effects)
• Retinitis Pigmentosa (diagnosis, physiopathology)
• Video Recording (instrumentation)
• Vision Disorders (diagnosis, physiopathology)
• Visual Field Tests (instrumentation, methods)
• Visual Fields (physiology)