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Ifat Sher-Rosenthal, Maya Gurevich, Yisroel Tucker, Amit Hamburg, Daniel BenNer, Jonathan Kfir, Estela Derazne, Ygal Rotenstreich; Chromatic pupilloperimetry for objective automated perimetry in retinitis pigmentosa patients.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6462.
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© ARVO (1962-2015); The Authors (2016-present)
Visual field (VF) evaluation is key for diagnosis and patient monitoring. Current VF methods are subjective. We present a novel automated objective perimetry in retinitis pigmentosa patients based on chromatic pupilloperimetry.
Pupillary light responses (PLR) to red and blue light presented at 54 different locations of a 24-degree visual field (VF) were determined in 10 retinitis pigmentosa patients and 32 age-matched controls. Blue and red light stimuli (peak 485 nm and 624 nm, respectively) were presented at light intensities of 170, 1000 cd /m^2, respectively. Fifteen parameters of the PR were evaluated including maximal percentage of pupil contraction (PPC), maximal velocity and acceleration of pupil contraction and dilation and their latencies. Patient's PR were compared to their subjective VF testing (Humphrey 24-2) and spectral domain optical coherence tomography (SD-OCT) findings.
Retinitis pigmentosa patients demonstrated substantially reduced percentage of pupil contraction in response to blue light. A milder defect was observed in the PR for red light. The average deviation in latency of maximal contraction velocity in response to red light between the VF targets was significantly higher in patients (p=0.000006) and indicated its usefulness as a diagnostic tool with high sensitivity and specificity (AUC=0.973). This parameter correlated with the patients' Humphrey MD score (Spearman rho r=-0.709, p=0.022) and mean ellipsoid zone area by SD-OCT (Spearman rho r=-0.619, p=0.028).
Objective perimetry and diagnosis of retinitis pigmentosa were obtained by chromatic pupilloperimetry. Multi-factorial analysis of the pupil response demonstrated significantly diminished pupil contraction and prolonged latency of maximal contraction velocity in areas with low light sensitivity by Humphrey perimetry. The response to blue light was more affected than the red light, in accordance with the primary defect in the rod system in these patients. Chromatic pupilloperimetry is effective for diagnosis and objective assessment of VF defects in retinitis pigmentosa patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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