Blue Multifocal Pupillographic Objective Perimetry in Glaucoma

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

doi:10.1167/iovs.14-16029

Cited by 37 publications

(63 citation statements)

References 60 publications

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“…Previous reports of mfVEP responses from occipital electrodes in patients with T2D showed only significant implicit time delays in the absence of retinopathy; however those delays correlated poorly with regions of loss on mfERG27. Using mfPOP stimuli we have recently confirmed earlier literature2128 showing that the pupillary system can be substantially driven by the visual cortex29, especially when using the transient stimuli of mfPOP24. Given those findings, and the brain lesion studies indicting substantial involvement of the extra-striate cortex in pupillary responses of primates and humans2230, we here compare the mfVEP responses from electrodes covering the occipital cortex, and surrounding electrodes that are more biased to extra-striate cortex, for any sign of the hypersensitivities in the subjects from those two studies.…”

supporting

confidence: 81%

“…1B,C,D). Anatomically the pupillary system receives significant input from the extra-striate cortex21, and we have demonstrated cortical input to the responses obtained from the types of transient mfPOP stimuli used here2429. Thus it seems plausible that observed hypersensitivities in mfPOP derive from extra-striate input.…”

Section: Discussionmentioning

confidence: 58%

“…The subjects with lesions also show red-green achromatopsia. The mfPOP method presents sparse trains of transiently presented stimuli, and we have shown that these significantly drive the cortical pathway to the PON1124.…”

mentioning

confidence: 92%

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Comparing multifocal pupillographic objective perimetry (mfPOP) and multifocal visual evoked potentials (mfVEP) in retinal diseases

Sabeti

James

Carle

et al. 2017

Sci Rep

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Multifocal pupillographic objective perimetry (mfPOP) shows regions of slight hypersensitivity away from retinal regions damaged by diabetes or age-related macular degeneration (AMD). This study examines if such results also appear in multifocal visual evoked potentials (mfVEPs) recorded on the same day in the same patients. The pupil control system receives input from the extra-striate cortex, so we also examined evidence for such input. We recruited subjects with early type 2 diabetes (T2D) with no retinopathy, and patients with unilateral exudative AMD. Population average responses of the diabetes patients, and the normal fellow eyes of AMD patients, showed multiple regions of significant hypersensitivity (p < 0.05) on both mfPOP and mfVEPs. For mfVEPs the occipital electrodes showed fewer hypersensitive regions than the surrounding electrodes. More advanced AMD showed regions of suppression becoming centrally concentrated in the exudative AMD areas. Thus, mfVEP electrodes biased towards extra-striate cortical responses (surround electrodes) appeared to show similar hypersensitive visual field locations to mfPOP in early stage diabetic and AMD damage. Our findings suggest that hypersensitive regions may be a potential biomarker for future development of AMD or non-proliferative diabetic retinopathy, and may be more informative than visual acuity which remains largely undisturbed during early disease.

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supporting

confidence: 81%

Section: Discussionmentioning

confidence: 58%

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Comparing multifocal pupillographic objective perimetry (mfPOP) and multifocal visual evoked potentials (mfVEP) in retinal diseases

Sabeti

James

Carle

et al. 2017

Sci Rep

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“…18 Such interplay lays the foundation for the use of chromatic pupillometry as a tool to evaluate the integrity of visual functions and localize retinal dysfunctions in various ocular diseases, [19][20][21] including glaucoma. [22][23][24][25] Whether using direct or consensual pupillometry, 26,27 concomitantly with full-field, regional, or multifocal chromatic illumination paradigms, [22][23][24][25]27,28 previous studies have shown that the PLR, and particularly the intrinsic melanopsin-mediated postillumination pupillary response (PIPR), is altered in moderate and advanced stages of glaucoma. These pupillometric alterations correlate with structural (e.g., cup-to-disc ratio) and functional (e.g., VF mean deviation [VFMD]) defects across disease severities.…”

mentioning

confidence: 99%

Pupillary Responses to Full-Field Chromatic Stimuli Are Reduced in Patients with Early-Stage Primary Open-Angle Glaucoma

et al. 2018

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“…9,[14][15][16][17][18][19][20][21][22][23] A different method of multifocal pupillographic perimetry (TrueField Analyzer; Tektronix, Beaverton, OR) uses white and colored stimuli analyzing both eyes simultaneously. [24][25][26] Although this technology is promising, it cannot differentiate between the rod and cone systems.…”

mentioning

confidence: 99%

Pupillometer-Based Objective Chromatic Perimetry in Normal Eyes and Patients With Retinal Photoreceptor Dystrophies

Skaat

Sher

Kolker

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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Citation: Skaat A, Sher I, Kolker A, et al. Pupillometer-based objective chromatic perimetry in normal eyes and patients with retinal photoreceptor dystrophies. Invest Ophthalmol Vis Sci. 2013;54;2761 -2770 . DOI:10.1167 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 308 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.)

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Blue Multifocal Pupillographic Objective Perimetry in Glaucoma

Abstract: In moderate to severe glaucoma, diagnostic accuracy of yellow and blue was similar, but blue stimuli showed limited ability to resolve scotomas. Blue mfPOP stimuli, however, may have advantages over yellow in detecting early glaucoma.

Cited by 37 publications

References 60 publications

Comparing multifocal pupillographic objective perimetry (mfPOP) and multifocal visual evoked potentials (mfVEP) in retinal diseases

Comparing multifocal pupillographic objective perimetry (mfPOP) and multifocal visual evoked potentials (mfVEP) in retinal diseases

Pupillary Responses to Full-Field Chromatic Stimuli Are Reduced in Patients with Early-Stage Primary Open-Angle Glaucoma

Pupillometer-Based Objective Chromatic Perimetry in Normal Eyes and Patients With Retinal Photoreceptor Dystrophies

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