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:10.1007/s40123-023-00738-5

Evaluation of the Glaucomatous Macular Damage by Chromatic Pupillometry

Ophthalmol Ther. 2023 Aug;12(4):2133-2156. doi: 10.1007/s40123-023-00738-5. Epub 2023 Jun 7.

Authors

Yadan Quan^#^{1

2

3}, Huiyu Duan^#⁴, Zongyi Zhan^{5

6

7}, Yuening Shen¹, Rui Lin^{1

2

3}, Tingting Liu^{1

2

3}, Ting Zhang^{1

2

3}, Jihong Wu^{1

2

3}, Jing Huang⁴, Guangtao Zhai⁴, Xuefei Song^{8

9}, Yixiong Zhou^{8

9}, Xinghuai Sun^{10

11

12

13}

Affiliations

¹ Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
² Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
³ NHC and Chinese Academy of Medical Sciences Key Laboratory of Myopia, Fudan University, Shanghai, China.
⁴ Institute of Image Communication and Network Engineering, Shanghai Jiao Tong University, Shanghai, China.
⁵ Shenzhen Eye Hospital, Shenzhen, China.
⁶ Shenzhen Eye Institute, Shenzhen, China.
⁷ Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China.
⁸ Department of Ophthalmology, Ninth People's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁹ Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
¹⁰ Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China. xhsun@shmu.edu.cn.
¹¹ Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. xhsun@shmu.edu.cn.
¹² NHC and Chinese Academy of Medical Sciences Key Laboratory of Myopia, Fudan University, Shanghai, China. xhsun@shmu.edu.cn.
¹³ State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China. xhsun@shmu.edu.cn.

^# Contributed equally.

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.

Keywords: Chromatic pupillometry; Macular structure; Primary open-angle glaucoma.

Abstract

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