title: Pupillometer-based objective chromatic perimetry in normal eyes and patients with retinal photoreceptor dystrophies.
abstract: OBJECTIVE
  To evaluate a novel objective perimetry using multifocal chromatic pupil light reflex in normal participants and patients with photoreceptor dysfunction, and to relate this new technique with subjective dark-adapted chromatic Goldmann perimetry.
  
  
  METHODS
  Thirty-two eyes of 17 retinitis pigmentosa (RP) or cone-rod dystrophy patients and 20 eyes of 12 healthy individuals were tested. A computerized infrared video pupillometer was used to record changes in pupil diameter in response to short- and long-wavelength stimuli (peak 485 and 640 nm, respectively; light intensity 40 cd/m(2)) at 13 different points of the 30° visual field (VF), under background illumination of 2.7 cd/m(2). The pupillary response (PR) of patients was compared with PR obtained from normal control participants. In 11 patients, the pupillary responses were also compared with their findings on dark-adapted chromatic Goldmann perimetry.
  
  
  RESULTS
  Significantly reduced pupillary responses were obtained in RP patients in response to the short-wavelength stimulus in nearly all perimetric locations (P < 0.03). By contrast, in response to the long-wavelength stimulus, RP patients demonstrated significantly reduced PR mostly in peripheral locations (P ≤ 0.02). In a cone-rod dystrophy patient, the PR to both long- and short-wavelength stimuli was significantly lower in the scotoma area identified by the dark-adapted chromatic Goldmann perimetry. In all patients that were tested by the chromatic Goldmann, minimal PR was recorded in areas that were nondetected in the chromatic Goldmann perimetry.
  
  
  CONCLUSIONS
  This study demonstrates the potential feasibility of using pupillometer-based chromatic perimetry for objectively assessing VF defects and retinal function in patients with retinal dystrophies. (ClinicalTrials.gov number, NCT01021982.).
authors.affiliation: The Maurice and Gabriela Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Skaat
authors.forename: Ifat
authors.initials: I
authors.lastname: Sher
authors.forename: Andrew
authors.initials: A
authors.lastname: Kolker
authors.forename: Sivan
authors.initials: S
authors.lastname: Elyasiv
authors.forename: Elkana
authors.initials: E
authors.lastname: Rosenfeld
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mhajna
authors.forename: Shlomo
authors.initials: S
authors.lastname: Melamed
authors.forename: Michael
authors.initials: M
authors.lastname: Belkin
authors.forename: Ygal
authors.initials: Y
authors.lastname: Rotenstreich
mesh_terms: D000328:Adult; D000368:Aged; D003623:Dark Adaptation; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D020419:Photoreceptor Cells, Vertebrate / Q000502:physiology*; D011680:Pupil / Q000502:physiology*; D012025:Reflex, Pupillary / Q000528:radiation effects; D012174:Retinitis Pigmentosa / Q000175:diagnosis / Q000503:physiopathology*; D014741:Video Recording / Q000295:instrumentation; D014786:Vision Disorders / Q000175:diagnosis / Q000503:physiopathology*; D058609:Visual Field Tests / Q000295:instrumentation / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*