دورية أكاديمية
أعرض في EDS

Pupillary Responses to High-Irradiance Blue Light Correlate with Glaucoma Severity.

التفاصيل البيبلوغرافية
العنوان: Pupillary Responses to High-Irradiance Blue Light Correlate with Glaucoma Severity.
المؤلفون: Rukmini AV; Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore., Milea D; Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore., Baskaran M; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore., How AC; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore., Perera SA; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore., Aung T; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore., Gooley JJ; Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore. Electronic address: joshua.gooley@duke-nus.edu.sg.
المصدر: Ophthalmology [Ophthalmology] 2015 Sep; Vol. 122 (9), pp. 1777-85.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : New York : Elsevier
Original Publication: Rochester, Minn., American Academy of Ophthalmology.
مواضيع طبية MeSH: Light*, Glaucoma, Open-Angle/*diagnosis , Optic Nerve Diseases/*diagnosis , Pupil Disorders/*diagnosis , Reflex, Pupillary/*radiation effects , Retinal Ganglion Cells/*pathology , Vision Disorders/*diagnosis, Aged ; Asian People ; Cross-Sectional Studies ; Female ; Glaucoma, Open-Angle/classification ; Humans ; Intraocular Pressure/physiology ; Male ; Middle Aged ; Ophthalmoscopy ; Tonometry, Ocular ; Visual Acuity/physiology ; Visual Field Tests ; Visual Fields/physiology
مستخلص: Purpose: To evaluate whether a chromatic pupillometry test can be used to detect impaired function of intrinsically photosensitive retinal ganglion cells (ipRGCs) in patients with primary open-angle glaucoma (POAG) and to determine if pupillary responses correlate with optic nerve damage and visual loss.
Design: Cross-sectional study.
Participants: One hundred sixty-one healthy controls recruited from a community polyclinic (55 men; 151 ethnic Chinese) and 40 POAG patients recruited from a glaucoma clinic (22 men; 35 ethnic Chinese) 50 years of age or older.
Methods: Subjects underwent monocular exposure to narrowband blue light (469 nm) or red light (631 nm) using a modified Ganzfeld dome. Each light stimulus was increased gradually over 2 minutes to activate sequentially the rods, cones, and ipRGCs that mediate the pupillary light reflex. Pupil diameter was recorded using an infrared pupillography system.
Main Outcome Measures: Pupillary responses to blue light and red light were compared between control subjects and those with POAG by constructing dose-response curves across a wide range of corneal irradiances (7-14 log photons/cm(2) per second). In patients with POAG, pupillary responses were evaluated relative to standard automated perimetry testing (Humphrey Visual Field [HVF]; Carl Zeiss Meditec, Dublin, CA) and scanning laser ophthalmoscopy parameters (Heidelberg Retinal Tomography [HRT]; Heidelberg Engineering, Heidelberg, Germany).
Results: The pupillary light reflex was reduced in patients with POAG only at higher irradiance levels, corresponding to the range of activation of ipRGCs. Pupillary responses to high-irradiance blue light associated more strongly with disease severity compared with responses to red light, with a significant linear correlation observed between pupil diameter and HVF mean deviation (r = -0.44; P = 0.005) as well as HRT linear cup-to-disc ratio (r = 0.61; P < 0.001) and several other optic nerve head parameters.
Conclusions: In glaucomatous eyes, reduced pupillary responses to high-irradiance blue light were associated with greater visual field loss and optic disc cupping. In POAG, a short chromatic pupillometry test that evaluates the function of ipRGCs can be used to estimate the degree of damage to retinal ganglion cells that mediate image-forming vision. This approach could prove useful in detecting glaucoma.
(Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20150825 Date Completed: 20151116 Latest Revision: 20221207
رمز التحديث: 20221213
DOI: 10.1016/j.ophtha.2015.06.002
PMID: 26299721
قاعدة البيانات: MEDLINE
الوصف
تدمد:1549-4713
DOI:10.1016/j.ophtha.2015.06.002