Effects of low and moderate refractive errors on chromatic pupillometry

Rukmini, Annadata; Chew, Milton C.; Finkelstein, Maxwell T.; Atalay, Eray; Baskaran, Mani; Nongpiur, Monisha E.; Gooley, Joshua J.; Aung, Tin; Miléa, Dan; Najjar, Raymond P.

doi:10.1038/s41598-019-41296-w

Cited by 10 publications

(15 citation statements)

References 53 publications

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“…31,33,37 Using a similar light paradigm, we have also reported that the PLR is unaffected by mild or moderate myopia. 39 Taken together, our results suggest that HCP using a ramping-up light paradigm can potentially be used to detect glaucoma in populations with a high prevalence of myopia, such as those in East Asia. 2–5…”

Section: Discussionsupporting

confidence: 56%

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Finkelstein

Nongpiur

Husain

et al. 2022

Preprint

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Purpose: To assess pupillary light responses (PLRs) in eyes with high myopia and evaluate the ability of handheld chromatic pupillometry (HCP) to identify glaucomatous functional loss in eyes with high myopia. Design: Cross-sectional study with prospective data collection. Methods: Participants included 28 emmetropes (EM), 24 high myopes without glaucoma (HM), and 17 high myopes with confirmed glaucoma (HMG), recruited at the Singapore National Eye Center. Monocular PLRs were evaluated using a custom-built handheld pupillometer that recorded changes in horizontal pupil radius in response to 9 seconds of exponentially increasing blue (469.1nm) and red (640.1nm) lights. Fifteen pupillometric features were compared between groups. A logistic regression model (LRM) was used to distinguish HMG eyes from non-glaucomatous eyes (EM and HM). Results: All pupillometric features were similar between EM and HM groups. Phasic constriction to blue (P<0.001) and red (P=0.006) lights, and maximum constriction to blue light (P<0.001) were reduced in HMG compared to EM and HM. Pupillometric features of melanopsin function (PIPR AUC 0-12s (P<0.001) and PIPR 6s (P=0.01) to blue light) were reduced in HMG. Using only three pupillometric features, the LRM could classify glaucomatous from non-glaucomatous eyes with an AUC of 0.89 (95%CI: 0.77-1.00), sensitivity 94.1% (82.4%-100.0%) and specificity 78.8% (67.3%-90.4%). Conclusions: PLRs to ramping-up light stimuli are unaltered in highly myopic eyes without other diagnosed ocular conditions. Conversely, HCP can distinguish glaucomatous functional loss in highly myopic eyes and may be a useful tool to detect/confirm the presence of glaucoma in patients with high myopia.

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Section: Discussionsupporting

confidence: 56%

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Finkelstein

Nongpiur

Husain

et al. 2022

Preprint

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“…These findings differ from those of Zhao et al (12) and Yao et al (18), who reported that halo size was only related to minimum pupil diameter under the same condition. Although pupillary responses might not be influenced by refractive errors (26)(27)(28), differences in pupil size (initial pupil diameter, pupil maxima, pupil minima, and average pupil diameter) among the three studies could be responsible for the difference. The pupil size, as controlled by the pupillary light reflex, determines both retinal illuminance and image quality (29).…”

Section: Discussionmentioning

confidence: 88%

Evaluation of Disk Halo Size and Identification of Correlated Factors in Myopic Adults

Zhao

Han

et al. 2022

Front. Med.

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This study aimed to evaluate glare source-induced disk halo size and assess its correlation with higher-order aberrations (HOAs), pupillometry findings, and contrast sensitivity in myopic adults (aged 23.8 ± 4.4 years). In this cross-sectional study, 150 eyes of 150 patients were assessed. All patients underwent routine ophthalmic examinations, wavefront aberrometry, halo size measurement, dynamic pupillometry, and contrast sensitivity tests. Spearman's correlation analysis and independent sample t-tests were performed for data analysis. The mean halo radius was 82.5 ± 21.8 and 236.7 ± 52.2 arc min at 5 and 1 cd/m2 luminance levels, respectively. The values were inversely correlated with internal spherical aberration (SA) (r = −0.175, p = 0.032 and r = −0.241, p = 0.003, respectively), but not correlated with spherical equivalent (SE, both p > 0.05). Positive correlations were observed between halo radius and pupil size, contraction amplitude, and dilation speed during pupillary light reflex. Halo radii at 5 and 1 cd/m2 luminance levels were not significantly correlated with the area under the log contrast sensitivity function (r = −0.093, p = 0.258 and r = −0.149, p = 0.069, respectively). The mean halo radius was not clinically different between myopic and healthy eyes at 5 cd/m2 luminance level and did not differ significantly between the high and low-to-moderate myopia at 5 and 1 cd/m2 luminance levels (all p > 0.05). According to a stepwise linear regression model, the internal SA had a negative effect on the halo radius under low photpic condition; the average pupil diameter, internal SA and corneal HOAs played a large role in determining the halo radius under mesopic condition.

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“…It has yet to be determined whether cPLR could also be used to evaluate the efficacy of gene therapy in achromatopsia patients. It is noteworthy that cPLR testing has also been reported in ametropic patients, and it has been demonstrated that constriction to bright red light is most significant in hyperopes 85,86 .…”

Section: Discussionmentioning

confidence: 97%

Naturally-occurring myopia and loss of cone function in a sheep model of achromatopsia

Ross

Ofri

Aizenberg

et al. 2020

Sci Rep

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Achromatopsia is an inherited retinal disease characterized by loss of cone photoreceptor function. Day blind CNGA3 mutant Improved Awassi sheep provide a large animal model for achromatopsia. This study measured refractive error and axial length parameters of the eye in this model and evaluated chromatic pupillary light reflex (cPLR) testing as a potential screening test for loss of cone function. Twenty-one CNGA3 mutant, Improved Awassi, 12 control Afec-Assaf and 12 control breed-matched wild-type (WT) Awassi sheep were examined using streak retinoscopy and B-mode ocular ultrasonography. Four CNGA3 mutant and four Afec-Assaf control sheep underwent cPLR testing. Statistical tests showed that day-blind sheep are significantly more myopic than both Afec-Assaf and WT Awassi controls. Day-blind sheep had significantly longer vitreous axial length compared to WT Awassi (1.43 ± 0.13 and 1.23 ± 0.06 cm, respectively, p < 0.0002) and no response to bright red light compared to both controls. Lack of response to bright red light is consistent with cone dysfunction, demonstrating that cPLR can be used to diagnose day blindness in sheep. Day-blind sheep were found to exhibit myopia and increased vitreous chamber depth, providing a naturally occurring large animal model of myopia.

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Effects of low and moderate refractive errors on chromatic pupillometry

Cited by 10 publications

References 53 publications

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Evaluation of Disk Halo Size and Identification of Correlated Factors in Myopic Adults

Naturally-occurring myopia and loss of cone function in a sheep model of achromatopsia

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