title: Chromatic Multifocal Pupillometer for Objective Perimetry and Diagnosis of Patients with Retinitis Pigmentosa.
abstract: To assess visual field (VF) defects and retinal function objectively in healthy participants and patients with retinitis pigmentosa (RP) using a chromatic multifocal pupillometer.
  
  
  
  Cross-sectional study.
  
  
  
  The right eyes of 16 healthy participants and 13 RP patients.
  
  
  
  Pupil responses to red and blue light (peak, 485 and 625 nm, respectively) presented by 76 light-emitting diodes, 1.8-mm spot size at different locations of a 16.2° VF were recorded. Subjective VFs of RP patients were determined using chromatic dark-adapted Goldmann VFs (CDA-GVFs). Six healthy participants underwent 2 pupillometer examinations to determine test-retest reliability.
  
  
  
  Three parameters of pupil contraction were determined automatically: percentage of change of pupil size (PPC), maximum contraction velocity (MCV; in pixels per second), and latency of MCV (LMCV; in seconds). The fraction of functional VF was determined by CDA-GVF.
  
  
  
  In healthy participants, higher PPC and MCV were measured in response to blue compared with red light. The LMCV in response to blue light was relatively constant throughout the VF. Healthy participants demonstrated higher PPC and MCV and shorter LMCV in central compared with peripheral test points in response to red light. Test-retest correlation coefficients were 0.7 for PPC and 0.5 for MCV. In RP patients, test point in which the PPC and MCV were lower than 4 standard errors from the mean of healthy participants correlated with areas that were indicated as nonseeing by CDA-GVF. The mean absolute deviation in LMCV parameter in response to the red light between different test point was significantly higher in RP patients (range, 0.16-0.47) than in healthy participants (range, 0.02-0.16; P < 0.0001) and indicated its usefulness as a diagnostic tool with high sensitivity and specificity (area under the receiver operating characteristic curve (AUC), 0.97, Mann-Whitney-Wilcoxon analysis). Randomly reducing the number of test points to a total of 15 points did not significantly reduce the AUC in RP diagnosis based on this parameter.
  
  
  
  This study demonstrates the feasibility of using a chromatic multifocal pupillometer for objective diagnosis of RP and assessment of VF defects.
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Chibel
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ifat
authors.initials: I
authors.lastname: Sher
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ben Ner
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Mohamad O
authors.initials: MO
authors.lastname: Mhajna
authors.affiliation: Department of Ophthalmology, Wolfson Medical Center, Holon, Israel.
authors.forename: Asaf
authors.initials: A
authors.lastname: Achiron
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Soad
authors.initials: S
authors.lastname: Hajyahia
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Skaat
authors.affiliation: Biostatistics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.
authors.forename: Yakir
authors.initials: Y
authors.lastname: Berchenko
authors.affiliation: Biostatistics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.
authors.forename: Bernice
authors.initials: B
authors.lastname: Oberman
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Unit of Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.
authors.forename: Ofra
authors.initials: O
authors.lastname: Kalter-Leibovici
authors.affiliation: Biostatistics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.
authors.forename: Laurence
authors.initials: L
authors.lastname: Freedman
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Ygal.Rotenstreich@sheba.health.gov.il.
authors.forename: Ygal
authors.initials: Y
authors.lastname: Rotenstreich
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003623:Dark Adaptation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011680:Pupil / Q000502:physiology* / Q000528:radiation effects; D012025:Reflex, Pupillary / Q000502:physiology*; D015203:Reproducibility of Results; D012174:Retinitis Pigmentosa / Q000175:diagnosis / Q000503:physiopathology*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields / Q000502:physiology*