Abstract
Purpose :
To test and identify diagnostic accuracy of a single binocular, lightweight pupillometer device, that measures the pupillary light reflex (PLR) and to determine the asymmetry of the PLR (afferent pupillary defect, APD) among normal subjects and subjects with various eye pathology.
Methods :
Data from subjects (N=150) with confirmed various ocular pathology (retinal diseases, optic nerve disease, refractive errors, amblyopia) and healthy subjects age 18 -70 yr were collected.
Patients with cloudy corneas and dense cataracts affecting the measurement of APD were excluded from the study.
Visual acuity (Snellen visual acuity chart), autorefraction (Auto-Ref-Keratometer), intraocular pressure (IOP) was measured using Goldman tonometry, slit lamp and fundus examination were obtained. The optic nerve and retina were measured with OCTA (Optovue Inc.).
The pupillary light reflex (PLR) of the right and left eye concurrently was measured and analyzed with binocular wearable pupillometer in all patients. Parameters included relative APD, APD in superior and inferior fields, amplitude, latency, time to max constriction.
Pupillometer images interpretation with a single-page report were exported and analyzed, according to a specified grading protocol.
Results :
All subjects were divided into 4 groups.
1.Patients who have asymmetric vision from either retinal or optic nerve disease without any other eye pathology.
2. Patients with significant asymmetric refractive errors without any other eye pathology.
3. Patients with monocular amblyopia without any other eye pathology.
4. Control groups with subjects with normal eye exam and normal pupillography test.
All groups had APD and pupillary abnormal parameters when compared with controls (p<0.03) with high sensitivity and specificity.
Conclusions :
The binocular pupillometer demonstrated good diagnostic accuracy in its ability to help diagnose afferent and efferent pupillary defects (including relative afferent pupillary defects) in a retinal and optic nerve pathologies, refractive errors and amblyopia. This findings demonstrates that pupillometer is a valuable adjunctive tool to assist in diagnosis and may provide a method for monitoring disease progression.
The device does not require a darkened room and requires minimal patient cooperation which makes test easy and accurate.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.