PDF(Pubmed)
Abstract：
UNASSIGNED: The aim of this study is to evaluate the utility of binocular chromatic pupillometry in detecting impaired pupillary light response (PLR) in patients with primary open-angle glaucoma (POAG) and to assess the feasibility of using binocular chromatic pupillometer in opportunistic POAG diagnosis in community-based or telemedicine-based services.
UNASSIGNED: In this prospective, cross-sectional study, 74 patients with POAG and 23 healthy controls were enrolled. All participants underwent comprehensive ophthalmologic examinations including optical coherence tomography (OCT) and standard automated perimetry (SAP). The PLR tests included sequential tests of full-field chromatic stimuli weighted by rods, intrinsically photosensitive retinal ganglion cells (ipRGCs), and cones (Experiment 1), as well as alternating chromatic light flash-induced relative afferent pupillary defect (RAPD) test (Experiment 2). In Experiment 1, the constricting amplitude, velocity, and time to maximum constriction/dilation were calculated in three cell type-weighted responses, and the post-illumination response of ipRGC-weighted response was evaluated. In Experiment 2, infrared pupillary asymmetry (IPA) amplitude and anisocoria duration induced by intermittent blue or red light flashes were calculated.
UNASSIGNED: In Experiment 1, the PLR of POAG patients was significantly reduced in all conditions, reflecting the defect in photoreception through rods, cones, and ipRGCs. The variable with the highest area under the receiver operating characteristic curve (AUC) was time to max dilation under ipRGC-weighted stimulus, followed by the constriction amplitude under cone-weighted stimulus and the constriction amplitude response to ipRGC-weighted stimuli. The impaired PLR features were associated with greater visual field loss, thinner retinal nerve fiber layer (RNFL) thickness, and cupping of the optic disk. In Experiment 2, IPA and anisocoria duration induced by intermittent blue or red light flashes were significantly greater in participants with POAG than in controls. IPA and anisocoria duration had good diagnostic value, correlating with the inter-eye asymmetry of visual field loss.
UNASSIGNED: We demonstrate that binocular chromatic pupillometry could potentially serve as an objective clinical tool for opportunistic glaucoma diagnosis in community-based or telemedicine-based services. Binocular chromatic pupillometry allows an accurate, objective, and rapid assessment of retinal structural impairment and functional loss in glaucomatous eyes of different severity levels.
UNASSIGNED: In this prospective, cross-sectional study, 74 patients with POAG and 23 healthy controls were enrolled. All participants underwent comprehensive ophthalmologic examinations including optical coherence tomography (OCT) and standard automated perimetry (SAP). The PLR tests included sequential tests of full-field chromatic stimuli weighted by rods, intrinsically photosensitive retinal ganglion cells (ipRGCs), and cones (Experiment 1), as well as alternating chromatic light flash-induced relative afferent pupillary defect (RAPD) test (Experiment 2). In Experiment 1, the constricting amplitude, velocity, and time to maximum constriction/dilation were calculated in three cell type-weighted responses, and the post-illumination response of ipRGC-weighted response was evaluated. In Experiment 2, infrared pupillary asymmetry (IPA) amplitude and anisocoria duration induced by intermittent blue or red light flashes were calculated.
UNASSIGNED: In Experiment 1, the PLR of POAG patients was significantly reduced in all conditions, reflecting the defect in photoreception through rods, cones, and ipRGCs. The variable with the highest area under the receiver operating characteristic curve (AUC) was time to max dilation under ipRGC-weighted stimulus, followed by the constriction amplitude under cone-weighted stimulus and the constriction amplitude response to ipRGC-weighted stimuli. The impaired PLR features were associated with greater visual field loss, thinner retinal nerve fiber layer (RNFL) thickness, and cupping of the optic disk. In Experiment 2, IPA and anisocoria duration induced by intermittent blue or red light flashes were significantly greater in participants with POAG than in controls. IPA and anisocoria duration had good diagnostic value, correlating with the inter-eye asymmetry of visual field loss.
UNASSIGNED: We demonstrate that binocular chromatic pupillometry could potentially serve as an objective clinical tool for opportunistic glaucoma diagnosis in community-based or telemedicine-based services. Binocular chromatic pupillometry allows an accurate, objective, and rapid assessment of retinal structural impairment and functional loss in glaucomatous eyes of different severity levels.
摘要：
■这项研究的目的是评估双目彩色瞳孔测量法在检测原发性开角型青光眼（POAG）患者瞳孔反应受损（PLR）中的实用性，并评估在基于社区或远程医疗的服务中使用双目彩色瞳孔测量仪进行机会性POAG诊断的可行性。
■在这个前景中，横断面研究，纳入74例POAG患者和23例健康对照。所有参与者都接受了全面的眼科检查，包括光学相干断层扫描（OCT）和标准自动视野检查（SAP）。PLR测试包括对杆加权的全场彩色刺激的顺序测试，固有光敏视网膜神经节细胞（ipRGC），和锥体（实验1），以及交替的彩色闪光引起的相对传入瞳孔缺损（RAPD）测试（实验2）。在实验1中，收缩幅度，速度,在三个细胞类型加权响应中计算了最大收缩/扩张时间，并评估了ipRGC加权响应的光照后响应。在实验2中，计算了由间歇性蓝光或红光闪烁引起的红外瞳孔不对称（IPA）幅度和不等眼持续时间。
■在实验1中，POAG患者的PLR在所有情况下均显着降低，通过杆反映光接收中的缺陷，锥体,和ipRGC。受试者工作特征曲线（AUC）下面积最高的变量是ipRGC加权刺激下的最大扩张时间，其次是锥形加权刺激下的收缩幅度和对ipRGC加权刺激的收缩幅度响应。受损的PLR特征与更大的视野丧失相关，较薄的视网膜神经纤维层（RNFL）厚度，和视盘的拔罐。在实验2中，患有POAG的参与者中，间歇性蓝光或红光闪烁引起的IPA和失电持续时间明显大于对照组。IPA和不等眼持续时间具有良好的诊断价值，与视野损失的眼间不对称性相关。
■我们证明，在基于社区或基于远程医疗的服务中，双眼色瞳孔测量法可能作为机会性青光眼诊断的客观临床工具。双目彩色瞳孔测量法允许准确的，目标,以及快速评估不同严重程度青光眼眼的视网膜结构损伤和功能丧失。
■在这个前景中，横断面研究，纳入74例POAG患者和23例健康对照。所有参与者都接受了全面的眼科检查，包括光学相干断层扫描（OCT）和标准自动视野检查（SAP）。PLR测试包括对杆加权的全场彩色刺激的顺序测试，固有光敏视网膜神经节细胞（ipRGC），和锥体（实验1），以及交替的彩色闪光引起的相对传入瞳孔缺损（RAPD）测试（实验2）。在实验1中，收缩幅度，速度,在三个细胞类型加权响应中计算了最大收缩/扩张时间，并评估了ipRGC加权响应的光照后响应。在实验2中，计算了由间歇性蓝光或红光闪烁引起的红外瞳孔不对称（IPA）幅度和不等眼持续时间。
■在实验1中，POAG患者的PLR在所有情况下均显着降低，通过杆反映光接收中的缺陷，锥体,和ipRGC。受试者工作特征曲线（AUC）下面积最高的变量是ipRGC加权刺激下的最大扩张时间，其次是锥形加权刺激下的收缩幅度和对ipRGC加权刺激的收缩幅度响应。受损的PLR特征与更大的视野丧失相关，较薄的视网膜神经纤维层（RNFL）厚度，和视盘的拔罐。在实验2中，患有POAG的参与者中，间歇性蓝光或红光闪烁引起的IPA和失电持续时间明显大于对照组。IPA和不等眼持续时间具有良好的诊断价值，与视野损失的眼间不对称性相关。
■我们证明，在基于社区或基于远程医疗的服务中，双眼色瞳孔测量法可能作为机会性青光眼诊断的客观临床工具。双目彩色瞳孔测量法允许准确的，目标,以及快速评估不同严重程度青光眼眼的视网膜结构损伤和功能丧失。
