June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Chromatic pupilloperimetry for diagnosis and monitoring of patients with brain tumors with no apparent contact with the visual or pupil light reflex systems
Author Affiliations & Notes
  • Daniel Moverman
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Ifat Sher
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Amit Hamburg
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Shlomit Zorani
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Estela Derazne
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Anton Wohl
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
    Department of Neurosurgery, Sheba Medical Center, Tel Aviv University, Israel, Tel Aviv-Yafo, Israel
  • Zvi Cohen
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
    Department of Neurosurgery, Sheba Medical Center, Tel Aviv University, Israel, Tel Aviv-Yafo, Israel
  • Ygal Rotenstreich
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  • Footnotes
    Commercial Relationships   Daniel Moverman, None; Ifat Sher, Sheba Medical Center (P); Amit Hamburg, None; Shlomit Zorani, None; Estela Derazne, None; Anton Wohl, None; Zvi Cohen, None; Ygal Rotenstreich, Sheba Medical Center (P)
  • Footnotes
    Support  Israeli Defense Force research grant
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2405. doi:
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      Daniel Moverman, Ifat Sher, Amit Hamburg, Shlomit Zorani, Estela Derazne, Anton Wohl, Zvi Cohen, Ygal Rotenstreich; Chromatic pupilloperimetry for diagnosis and monitoring of patients with brain tumors with no apparent contact with the visual or pupil light reflex systems. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2405.

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

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Abstract

Purpose : To characterize the pupil light responses (PLR) for small focal chromatic light stimuli presented in peripheral and central retinal locations in patients with a mass effect due to brain tumors with no apparent contact with the visual or PLR systems.

Methods : The PLR for small (0.43°) blue and red-light stimuli presented at peripheral (21°) and central (4.2°) visual field (VF) locations were measured using chromatic pupilloperimetry in 6 patients with brain tumors with no apparent contact with the visual or PLR systems and 32 age-similar controls. All subjects underwent a complete ophthalmic exam, standard Humphrey automated perimetry (24-2), color vision test, best-corrected visual acuity, refraction and Spectral-Domain Optical Coherence Tomography (SD-OCT) imaging. All patients underwent brain MRI before and following tumor removal surgery.

Results : The SD-OCT thicknesses of macular ganglion cell and inner plexiform layers, as well as peripapillary retinal nerve fiber layer, were within normal limits in all patients. Differences in cone-mediated PLR were statistically insignificant between patients and controls. By contrast, rod-mediated percentage of maximal pupil contraction was significantly lower in patients compared to controls in the center of the VF (mean ± SD: 11% ±4 % vs. 16 %±5 %, p= 0.028, ROC AUC=86.6%, p=0.005). Melanopsin-mediated PLR was attenuated in the peripheral VF (p=0.005, ROC AUC=95.3% p=0.001). The rod- but not the melanopsin-mediated PLR recovered by 4 weeks post-OP.

Conclusions : Chromatic pupilloperimetry may present a fast, objective non-invasive test for diagnosis and monitoring of patients with brain tumors with no apparent contact with the visual or PLR systems. Short and long term mass effects on PLR pathways can be identified by multiparametric analysis of the PLR for focal chromatic stimuli at central and peripheral VF. Localized melanopsin-mediated sustained PLR may provide a novel surrogate biomarker for mass effects.

This is a 2021 ARVO Annual Meeting abstract.

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