Pupillary light reflex as a diagnostic aid from computational viewpoint: A systematic literature review

Pinheiro, Hedenir Monteiro; Costa, Ronaldo Martins da

doi:10.1016/j.jbi.2021.103757

Cited by 23 publications

(19 citation statements)

References 216 publications

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“…Finally, most of these studies used customized pupillometers not readily accessible for clinical use. Using a commercially available pupillometer, such as the NeurOptics NPi-200 or RAPDx (Konan Medical) in future research, may facilitate translation into clinical practice (107).…”

Section: Resultsmentioning

confidence: 99%

Tracking Eye Movements for Diagnosis in Myasthenia Gravis: A Comprehensive Review

Nguyen

Walt²,

Fielding³

et al. 2022

Journal of Neuro-Ophthalmology

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Section: Resultsmentioning

confidence: 99%

Tracking Eye Movements for Diagnosis in Myasthenia Gravis: A Comprehensive Review

Nguyen

Walt²,

Fielding³

et al. 2022

Journal of Neuro-Ophthalmology

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“…2), Neuroptics NPi-200 (Neuroptics, Irvine, CA), RAPDx, and Kinetic Eyes (EyeKinetix, Konan Medical USA, Irvine, CA) 14–16 . In addition to standard features of pupil stimulation and recording, these devices also have their unique features that facilitate specific use cases within and outside of neurophthalmology 26–29 . For instance, the RAPDx can perform chromatic pupillometry, Kinetic Eyes can perform a visual field assessment along with white light and chromatic pupillometry, and the Neuroptics Npi-200 allows variation in the duration and intensity of white light stimulation and generates its own Npi index for quantifying monocular pupillary defects 30 .…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] In addition to standard features of pupil stimulation and recording, these devices also have their unique features that facilitate specific use cases within and outside of neurophthalmology. [26][27][28][29] For instance, the RAPDx can perform chromatic pupillometry, Kinetic Eyes can perform a visual field assessment along with white light and chromatic pupillometry, and the Neuroptics Npi-200 allows variation in the duration and intensity of white light stimulation and generates its own Npi index for quantifying monocular pupillary defects. 30 Most of these devices are also portable, are easy to use in terms of patient alignment and instructions, and can be performed by a minimally trained human resource.…”

Section: Study Limitationsmentioning

confidence: 99%

Effect of Light Intensity on the Relative Afferent Pupillary Defect in Unilateral Neuro-ophthalmic Pathology

Negi,

Raviselvan,

Yarravarapu

et al. 2023

Optom Vis Sci

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SIGNIFICANCE Objective pupillometry with standardized light intensities allows a comprehensive assessment of the relative afferent pupillary defect in patients with unilateral neuro-ophthalmic pathology. PURPOSE This study aimed to determine the impact of varying light intensities on the grade of relative afferent pupillary defect in unilateral neuro-ophthalmic pathology vis-à-vis healthy controls. METHODS Monocular pupillary light reflexes of 20 controls (14 to 50 years) and 31 cases (12 to 72 years) with clinically diagnosed relative afferent pupillary defect were measured thrice using 1-second-long light pulses, followed by 3 seconds of darkness, at eight light intensities (6.4 to 1200 lux) using objective pupillometry. The relative afferent pupillary defect was quantified as the ratio of the percentage change in the direct light reflexes of the left and right eyes. Its change with light intensity was described using standard exponential fits. RESULTS The median (25th to 75th interquartile range) defect score of 54.8% cases decreased from baseline values of 1.58 (1.25 to 1.87) for right eye pathology and 0.45 (0.39 to 0.55) for left eye pathology to saturation values of 1.18 (1.05 to 1.31) and 0.98 (0.95 to 1.06), respectively, at light intensities between 56.9 and 300.5 lux. Like controls (1.01 [1.00 to 1.06]), the defect scores of the remaining 45.2% cases were constant with light intensity at 1.23 (1.18 to 1.46) and 0.87 (0.86 to 0.89) for right and left eye pathologies, respectively. CONCLUSIONS Relative afferent pupillary defects may decrease with test light intensity in a significant proportion of patients with unilateral neuro-ophthalmic pathology. This highlights the importance of objective pupillometry with standardization light intensities for clinical assessment of afferent pupillary defects.

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“…Today, the pupil behavior has become an interdisciplinary field of research (La Morgia et al, 2018;Schneider et al, 2020;Joshi, 2021;Pinheiro and da Costa, 2021) in which the number of involved scientists rises, as the trend of the number of publications with the keywords "pupil diameter" or "pupillometry" reveals (Figure 2). The renewed attention to the temporal pupil aperture (Binda and Gamlin, 2017), its application in clinical diagnostics (Granholm et al, 2017;Joyce et al, 2018;Chougule et al, 2019;Kercher et al, 2020;Tabashum et al, 2021) and increasing popularity of chromatic pupillometry (Rukmini et al, 2017;Crippa et al, 2018) topics requires additional efforts in terms of standardization and provision of consistent tools, contributing to comparability in measurement and pre-processing methodologies.…”

Section: The Rising Popularity Of Pupil Light Response Researchmentioning

confidence: 99%

PupilEXT: Flexible Open-Source Platform for High-Resolution Pupillometry in Vision Research

et al. 2021

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The human pupil behavior has gained increased attention due to the discovery of the intrinsically photosensitive retinal ganglion cells and the afferent pupil control path’s role as a biomarker for cognitive processes. Diameter changes in the range of 10–2 mm are of interest, requiring reliable and characterized measurement equipment to accurately detect neurocognitive effects on the pupil. Mostly commercial solutions are used as measurement devices in pupillometry which is associated with high investments. Moreover, commercial systems rely on closed software, restricting conclusions about the used pupil-tracking algorithms. Here, we developed an open-source pupillometry platform consisting of hardware and software competitive with high-end commercial stereo eye-tracking systems. Our goal was to make a professional remote pupil measurement pipeline for laboratory conditions accessible for everyone. This work’s core outcome is an integrated cross-platform (macOS, Windows and Linux) pupillometry software called PupilEXT, featuring a user-friendly graphical interface covering the relevant requirements of professional pupil response research. We offer a selection of six state-of-the-art open-source pupil detection algorithms (Starburst, Swirski, ExCuSe, ElSe, PuRe and PuReST) to perform the pupil measurement. A developed 120-fps pupillometry demo system was able to achieve a calibration accuracy of 0.003 mm and an averaged temporal pupil measurement detection accuracy of 0.0059 mm in stereo mode. The PupilEXT software has extended features in pupil detection, measurement validation, image acquisition, data acquisition, offline pupil measurement, camera calibration, stereo vision, data visualization and system independence, all combined in a single open-source interface, available at https://github.com/openPupil/Open-PupilEXT.

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Pupillary light reflex as a diagnostic aid from computational viewpoint: A systematic literature review

Cited by 23 publications

References 216 publications

Tracking Eye Movements for Diagnosis in Myasthenia Gravis: A Comprehensive Review

Tracking Eye Movements for Diagnosis in Myasthenia Gravis: A Comprehensive Review

Effect of Light Intensity on the Relative Afferent Pupillary Defect in Unilateral Neuro-ophthalmic Pathology

PupilEXT: Flexible Open-Source Platform for High-Resolution Pupillometry in Vision Research

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