title: Diagnostic Ability of Automated Pupillography in Glaucoma.
abstract: To evaluate the diagnostic ability of automated pupillography measurements in glaucoma and study the effect of inter-eye asymmetry in glaucomatous damage on the diagnostic ability.
  
  
  
  In an observational, cross-sectional study, 47 glaucoma patients and 42 control subjects underwent automated pupillography using a commercially available device. Diagnostic abilities of the pupillary response measurements were evaluated using area under receiver operating characteristic (ROC) curves (AUC) and sensitivities at fixed specificities. Influence of inter-eye asymmetry in glaucoma [inter-eye mean deviation (MD) difference on visual fields (VF)] on the diagnostic ability of pupillography parameters was evaluated by ROC regression approach.
  
  
  
  The AUCs of automated pupillography parameters ranged from 0.60 (amplitude score with peripheral blue stimulus) to 0.82 (amplitude score with full field white stimulus, Amp-FF-W). Sensitivity at 95% specificity ranged between 5% (amplitude score with full field blue stimulus) and 45% (amplitude score with full field green stimulus). Inter-eye MD difference significantly affected the diagnostic performance of automated pupillography parameters (p < 0.05). AUCs of Amp-FF-W at inter-eye MD difference of 0 dB, 5 dB, 10 dB and 15 dB were 0.71, 0.80, 0.87 and 0.93, respectively, according to the regression model. The corresponding sensitivities at 95% specificity were 20%, 34%, 50% and 66%, respectively.
  
  
  
  The diagnostic abilities of even the best automated pupillography parameters were only moderate in glaucoma. The performance of these pupillography measurements in detecting glaucoma significantly increased with greater inter-eye asymmetry in the glaucomatous damage.
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Harsha L
authors.initials: HL
authors.lastname: Rao
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Sujatha V
authors.initials: SV
authors.lastname: Kadambi
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Mehta
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Srilakshmi
authors.initials: S
authors.lastname: Dasari
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Narendra K
authors.initials: NK
authors.lastname: Puttaiah
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Zia S
authors.initials: ZS
authors.lastname: Pradhan
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Dhanraj A S
authors.initials: DAS
authors.lastname: Rao
authors.affiliation: a Department of Glaucoma, Narayana Nethralaya, Rajajinagar , Bangalore , Karnataka , India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D004867:Equipment Design; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000503:physiopathology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D011446:Prospective Studies; D011680:Pupil; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*
keywords: Automated pupillography; diagnostic ability; glaucoma