Correlation Between Inter-Eye Difference in Average Retinal Nerve Fiber Layer Thickness and Afferent Pupillary Response as Measured by an Automated Pupillometer in Glaucoma

J Glaucoma. 2016 Mar;25(3):312-6. doi: 10.1097/IJG.0000000000000213.

Abstract

Purpose: To assess the correlations between the relative afferent pupillary defect measured by a binocular, computerized, and commercially available pupillometer and the inter-eye differences in average retinal nerve fiber layer (RNFL) thickness measured by spectral-domain optical coherence tomography (SD-OCT) and visual field index (VFI) and mean deviation (MD) measured by automated static perimetry in patients with glaucoma.

Design: Cross-sectional study.

Participants: Thirty four patients with open-angle glaucoma.

Methods: Pupillary constriction amplitudes were measured with an automated pupillometer. SD-OCT imaging of the circumpapillary RNFL and automated static perimetry were performed within 6 months of pupillometry.

Main outcome measures: Main outcome measures included Spearman correlation coefficients between relative afferent pupillary defect as measured by pupillometry and inter-eye differences in average RNFL thickness, VFI, and MD.

Results: Correlation coefficients between relative afferent pupillary defect and inter-eye difference in average RNFL thickness, MD, and VFI were -0.81 (P<0.001), -0.73 (P<0.001), and -0.68 (P<0.001), respectively.

Conclusions: The automated pupillometer quantifies asymmetry in afferent pupillary responses in proportion to structural and functional asymmetry as measured SD-OCT and automated static perimetry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diagnostic Techniques, Ophthalmological / instrumentation*
  • Female
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Pupil / physiology
  • Pupil Disorders / diagnosis*
  • Retinal Ganglion Cells / pathology*
  • Tomography, Optical Coherence / methods
  • Visual Field Tests / methods
  • Visual Fields / physiology