Quadrant Field Pupillometry Detects Melanopsin Dysfunction in Glaucoma Suspects and Early Glaucoma.
It is difficult to detect visual function deficits in patients at risk for glaucoma (glaucoma suspects) and at early disease stages with conventional ophthalmic tests such as perimetry. To this end, we introduce a novel quadrant field measure of the melanopsin retinal ganglion cell mediated pupil light response corresponding with typical glaucomatous arcuate visual field defects. The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 46 patients with different stages of glaucoma including glaucoma suspects and compared to a healthy group of 21 participants with no disease. We demonstrate that the superonasal quadrant PIPR differentiated glaucoma suspects and early glaucoma patients from controls with fair (AUC = 0.74) and excellent (AUC = 0.94) diagnostic accuracy, respectively. The superonasal PIPR provides a linear functional correlate of structural retinal nerve fibre thinning in glaucoma suspects and early glaucoma patients. This first report that quadrant PIPR stimulation detects melanopsin dysfunction in patients with early glaucoma and at pre-perimetric stages may have future implications in treatment decisions of glaucoma suspects.
Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia.|School of Optometry and Vision Science, Queensland University of Technology, Brisbane, QLD, Australia.
Prakash
P
Adhikari
Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia.|School of Optometry and Vision Science, Queensland University of Technology, Brisbane, QLD, Australia.
Andrew J
AJ
Zele
Queensland Eye Institute, South Brisbane, QLD, Australia.|University of Queensland, Brisbane, QLD, Australia.
Ravi
R
Thomas
Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia.|Queensland Eye Institute, South Brisbane, QLD, Australia.|School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
Beatrix
B
Feigl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D012025:Reflex, Pupillary / Q000187:drug effects / Q000502:physiology; D012160:Retina / Q000503:physiopathology*; D012165:Retinal Ganglion Cells; D017299:Rod Opsins / Q000627:therapeutic use*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields / Q000502:physiology; D000099210:Melanopsin
D017299:Rod Opsins; D000099210:Melanopsin