Luminance and colour variant pupil perimetry in glaucoma.
BACKGROUND
This study investigated the diagnostic utility for glaucoma of multifocal pupillographic objective perimetry stimuli targeting different components of the pupillary response: cortically derived colour responses and subcortical luminance responses.


METHODS
Observational cross-sectional study undertaken at the Australian National University.


METHODS
Thirty-five eyes of 24 glaucoma subjects and 46 eyes of 23 normal subjects.


METHODS
Subjects were tested with three multifocal pupillographic objective perimetry stimulus variants. The luminance-only variant (YYbal) utilized yellow stimuli on a yellow background; mixed colour and luminance protocols utilized green stimuli on a red background (RGbal, RG). Stimuli of 33 ms duration were presented at mean intervals of 4 s/region.


METHODS
Pupil constriction amplitude and time to peak. Area under the receiver operating characteristic curve was the main measure of sensitivity and specificity for glaucoma.


RESULTS
Colour and luminance protocols were more accurate at differentiating glaucoma subjects from normal subjects than the luminance-only protocol, and produced the largest reductions in amplitudes. This type of protocol also produced the highest overall sensitivity and specificity for glaucoma (receiver operating characteristic % area under the curve: severe, 100%; moderate, 94.4%; mild, 71.0%). Pattern deviations tended to produce higher area under the receiver operating characteristic curves in eyes classified as mild. Significant differences in the means of the six worst amplitude deviations were observed between normal and severe glaucoma subjects only.


CONCLUSIONS
Stimuli targeting both cortical pupillary colour response and subcortical pupillary luminance response components produced higher diagnostic accuracy than stimuli targeting subcortical pupillary luminance responses alone. Inclusion of constriction latencies further improved accuracy.
ARC Centre of Excellence in Vision Science, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia.
Corinne F
CF
Carle
Andrew C
AC
James
Maria
M
Kolic
Rohan W
RW
Essex
Ted
T
Maddess
D000368:Aged; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008027:Light; D008297:Male; D008875:Middle Aged; D011680:Pupil / Q000528:radiation effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*
glaucoma; pupil; pupillary reflex; visual field test