High‐ versus low‐density multifocal pupillographic objective perimetry in glaucoma

Maddess, Ted; Essex, Rohan W.; Kolic, Maria; Carle, Corinne F.; James, Andrew

doi:10.1111/ceo.12016

Cited by 14 publications

(10 citation statements)

References 25 publications

(66 reference statements)

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“…Z-score deviations from average normal responses were then calculated, incorporating a decibel offset for sex, because mfPOP responses are typically smaller in females. 45 ROC curves were calculated using these z-scores for the means of varying-sized subsets of the most deviating testregions of each eye, from the single worst-performing region (n-worst ¼ 1), the mean of the 2 worst-performing regions (nworst ¼ 2), to the mean of all 44 test-region deviations of each field (n-worst ¼ 44).…”

Section: Response Estimationmentioning

confidence: 99%

Blue Multifocal Pupillographic Objective Perimetry in Glaucoma

Carle

James

Kolic

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Section: Response Estimationmentioning

confidence: 99%

Blue Multifocal Pupillographic Objective Perimetry in Glaucoma

Carle

James

Kolic

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…Several pupil perimetry studies propose that the visual sensitivity maps measured with pupil perimetry are qualitatively comparable to visual sensitivity maps from threshold perimetry [e.g., ( 14 )]. One meta-analysis and several recent publication on multifocal pupillographic perimetry reported quantitative evidence for pupil perimetry's effectiveness in detecting glaucoma ( 13 , 15 – 18 ). Some additional evidence exists in favor of the effectiveness of pupil perimetry in diagnosing patients with damage to the optic tract, to or near the lateral geniculate nucleus, or to the occipital lobes.…”

Section: Introductionmentioning

confidence: 99%

Gaze-Contingent Flicker Pupil Perimetry Detects Scotomas in Patients With Cerebral Visual Impairments or Glaucoma

et al. 2018

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Background: The pupillary light reflex is weaker for stimuli presented inside as compared to outside absolute scotomas. Pupillograph perimetry could thus be an objective measure of impaired visual processing. However, the diagnostic accuracy in detecting scotomas has remained unclear. We quantitatively investigated the accuracy of a novel form of pupil perimetry.Methods: The new perimetry method, termed gaze-contingent flicker pupil perimetry, consists of the repetitive on, and off flickering of a bright disk (2 hz; 320 cd/m2; 4° diameter) on a gray background (160 cd/m2) for 4 seconds per stimulus location. The disk evokes continuous pupil oscillations at the same rate as its flicker frequency, and the oscillatory power of the pupil reflects visual sensitivity. We monocularly presented the disk at a total of 80 locations in the central visual field (max. 15°). The location of the flickering disk moved along with gaze to reduce confounds of eye movements (gaze-contingent paradigm). The test lasted ~5 min per eye and was performed on 7 patients with cerebral visual impairment (CVI), 8 patients with primary open angle glaucoma (age >45), and 14 healthy, age/gender-matched controls.Results: For all patients, pupil oscillation power (FFT based response amplitude to flicker) was significantly weaker when the flickering disk was presented in the impaired as compared to the intact visual field (CVI: 12%, AUC = 0.73; glaucoma: 9%, AUC = 0.63). Differences in power values between impaired and intact visual fields of patients were larger than differences in power values at corresponding locations in the visual fields of the healthy control group (CVI: AUC = 0.95; glaucoma: AUC = 0.87). Pupil sensitivity maps highlighted large field scotomas and indicated the type of visual field defect (VFD) as initially diagnosed with standard automated perimetry (SAP) fairly accurately in CVI patients but less accurately in glaucoma patients.Conclusions: We provide the first quantitative and objective evidence of flicker pupil perimetry's potential in detecting CVI-and glaucoma-induced VFDs. Gaze-contingent flicker pupil perimetry is a useful form of objective perimetry and results suggest it can be used to assess large VFDs with young CVI patients whom are unable to perform SAP.

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“…Promising results have been obtained in the assessment of glaucoma and other eye diseases using recently developed multifocal pupillographic objective perimetry (mfPOP) . Those studies, and others on normal subjects, have mostly employed transient luminance stimuli, with pupillary constrictions largely mediated by the subcortical pupillary luminance response .…”

Section: Introductionmentioning

confidence: 99%

“…Promising results have been obtained in the assessment of glaucoma and other eye diseases using recently developed multifocal pupillographic objective perimetry (mfPOP). [1][2][3][4][5][6][7][8] Those studies, and others on normal subjects, [9][10][11][12] have mostly employed transient luminance stimuli, with pupillary constrictions largely mediated by the subcortical pupillary luminance response. 13,14 Pupillary constrictions, however, can be elicited by changes in colour, [15][16][17] coherent motion, 18 flicker 19,20 or spatial content, [21][22][23] even in the absence of net changes in luminance.…”

Section: Introductionmentioning

confidence: 99%