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M.L. Rosenberg, R.J. Clarke; Pupillographic Evaluation in Patients With Pituitary Tumors . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1962.
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Purpose: To determine if the extent of optic fiber damage in patients with chiasmal lesions can be assessed objectively and accurately with pupillometry. Methods: 14 patients with radiographically documented chiasmal lesions were tested with both binocular pupillometry and Humphries automated perimetry. The percentage of crossing fibers from each eye was calculated from pupil responses to hemifield stimulation using an algebraic model of the pupillary light reflex pathway. A ratio of the total threshold sensitivity in the temporal visual field divided by the total visual sensitivity of the whole eye was obtained from Humphries automated perimetry. A similar ratio was calculated using only the 16 most central points. The ratios obtained via visual fields were compared to those obtained with pupillary stimulation and correlated using a linear regression analysis. Results: 26 eyes of the 14 patients were used, as 2 were blind. One patient was tested on three occasions and another twice. Thus 32 crossing percentages were calculated. The correlation between visual field and pupil testing was slightly better for peripheral (r = .63) than central fields (r = 0.6), although both were highly significant (p < 0.000). Conclusions: The close correlation between calculated estimates of optic fiber damage in patients with chiasmal lesions using pupillometry and Humphries automated perimetry suggests that pupillometry is a reasonably accurate method of estimating fiber damage. We hope such testing will serve as an objective measure of visual function and assist in the management of patients with chiasmal disease.
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