Measuring RAPD with infrared computerized pupillometry can detect optic neuropathy in glaucoma with high sensitivity and specificity. The method is fast and objective. Pupil area amplitude measurements were superior to pupil velocity measurements for the detection of RAPD in glaucoma.
Purpose: To develop a new technique for measuring relative afferent pupillary defect (RAPD) and to find the best stimulus parameters for detecting glaucomatous optic neuropathy. Methods: With a newly constructed pupillometer based on digital video recording, pupillary light reflexes were analyzed during alternating light stimulation. Pupil area was measured in each video frame using computer digital image analysis. The examinations were performed using different sets of stimulus-pause combinations. Subjects with unilateral or asymmetrical glaucoma were studied and compared to normals. Results: Alternating light stimulation of 0.5-s followed by 1-s pause was shown to be the best stimulus pattern for RAPD detection. Conclusion: Infrared pupillometry could distinguish eyes with glaucoma from normal eyes with good sensitivity and specificity.
The HRT is a useful tool for long-term follow-up of glaucomatous optic neuropathy. Digital image processing of HRT change images could facilitate the detection of progressive change.
Measuring RAPD with infrared computerized pupillometry can detect optic neuropathy in glaucoma with high sensitivity and specificity. The method is fast and objective. Pupil area amplitude measurements were superior to pupil velocity measurements for the detection of RAPD in glaucoma.
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