April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Pupillary light reflex using Dual Mode Confocal Scanning Laser Ophthalmoscope (cSLO) in patients with diabetic retinopathy
Author Affiliations & Notes
  • Shyam S Chaurasia
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    SRP in Neuroscience and Behavioral Disorders, Duke-NUS Granduate Medical School, Singapore, Singapore
  • Saravana Kumar
    Institute of Bioengineering and Nanotechnology, A*Star, Singapore, Singapore
  • Gemmy Chui Ming Cheung
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    Singapore National Eye Centre, Singapore, Singapore
  • Gavin S Tan
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    Singapore National Eye Centre, Singapore, Singapore
  • Govindarajan Jayaraman
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
  • Hla Myint Htoon
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
  • Mohammad Kamran Ikram
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Dan Milea
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    SRP in Neuroscience and Behavioral Disorders, Duke-NUS Granduate Medical School, Singapore, Singapore
  • Veluchamy A Barathi
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Tien Y Wong
    Retina Research Group, Singapore Eye Research Institute, Singapore, Singapore
    Singapore National Eye Centre, Singapore, Singapore
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4841. doi:
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    • Get Citation

      Shyam S Chaurasia, Saravana Kumar, Gemmy Chui Ming Cheung, Gavin S Tan, Govindarajan Jayaraman, Hla Myint Htoon, Mohammad Kamran Ikram, Dan Milea, Veluchamy A Barathi, Tien Y Wong; Pupillary light reflex using Dual Mode Confocal Scanning Laser Ophthalmoscope (cSLO) in patients with diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4841.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To measure pupillary light reflex (PLR) using a dual mode confocal Scanning Laser Ophthalmoscope (cSLO) in diabetic patients with varying degree of diabetic retinopathy (DR).

Methods: In this prospective case control study, 90 subjects aged 35-80 years with diabetes mellitus (DM) and varying grades of DR were recruited from a diabetic retinopathy clinic. Exclusion criteria included patients with any other eye conditions, intraocular surgeries/treatments interfering with the PLR recording. Patients were given 1% tropicamide for pupil dilation and dark adapted for 40 minutes before performing retinal imaging with cSLO (Heidelberg Retina Angiograph 2). Pupillometric measurements were obtained using the infra-red (IR) reflectance mode, allowing a high pupil-iris contrast. The photic stimulus was a blue laser light, projected repeatedly for 5 seconds every 5 second intervals for 3 minutes. Pupil IR images were captured every 1 second and 12 PLR parameters were analyzed. All subjects underwent standardized clinical examination and retinal photography which were graded for the presence and severity of DR using the modified Airlie House classification system.

Results: There were 40 subjects with no DR, 20 with mild DR, 15 with moderate DR and 15 with severe DR. Among the 12 parameters, 4 showed significant difference in patients with varying degrees of DR. In patients with severe DR there was a significant reduction of the pupil constriction (p=0.001) as well as pupil re-dilation (p=0.002) compared to patients with mild and moderate DR. Average pupil size in moderate DR patients was smaller compared to healthy controls (p=0.041), and patients with severe DR had the smallest ratio of pupil maxima/pupil minima.

Conclusions: Four out of twelve pupillary light reflex parameters recorded with dual mode cSLO showed significant associations with varying degree of DR. Future research is needed to establish whether dual mode cSLO could be implemented for the early detection of DR.

Keywords: 499 diabetic retinopathy • 550 imaging/image analysis: clinical • 668 pupillary reflex  
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