Evaluation of Pupil Fields Using a Newly Developed Perimeter in Glaucoma Patients

ABSTRACT

Purpose: To evaluate objective pupil fields using a newly developed perimeter for the detection of glaucomatous damage.

Materials and Methods: Forty-three eyes of 32 glaucoma patients (42–69 years) were examined. Glaucomatous eyes were classified into three stages using the Hodapp–Anderson–Parrish grading scale (early, 16; moderate, 14; and severe, 13 eyes). The head-mounted perimeter “imo” was used to measure the percentage pupil constriction (PPC) of the pupil fields at 36 test points. A stimulus target size of Goldmann V with 0 decibels (dB) light under 31.4 apostilbs (asb) background was presented. Visual fields were measured with the Humphrey Field Analyzer 10–2 program. Using the 3D OCT-2000, 10 × 10 grid of the macular thickness were also obtained. Median correlation coefficients (r) of each examined eye were analyzed between the PPC and visual field sensitivity (dB), and the thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL)⁺ (GCL + inner plexiform layer [IPL]), and GCL⁺⁺ (RNFL + GCL + IPL), respectively.

Results: Moderate correlations between the PPC and dB (r = 0.44–0.55), and GCL⁺⁺ (r = 0.43–0.45) were obtained in the correspondence analysis of 12 test points. There were no significant differences in glaucoma severity (P = 0.924–1.000). However, some patients with extremely early stage glaucoma (visual field index ≥90%) tended to have poor correlation.

Conclusions: Pupil fields of the imo generally corresponded to the visual fields and the RNFL + GCL + IPL thickness, even in early glaucoma; however, the examiner must clearly understand the criteria of patient selection.

KEYWORDS:

• Pupil field
• pupillary response
• visual field
• macular thickness
• glaucoma

Acknowledgments

The authors thank Robert E. Brandt, Founder, CEO, and CME, of MedEd Japan, for editing the manuscript. The funders donated the imo device, free of charge, for 2 years.

Disclosure statement

Disclosure: K. Asakawa, Funded by CREWT Medical Systems; K. Totsuka, None; H. Ishikawa, None; N. Shoji, None

Additional information

Funding

This work was supported by the Kitasato University School of Allied Health Sciences Grant in-Aid for Research Project [grant number 2018-1041]; CREWT Medical Systems [grant number 28-12232]; and JSPS KAKENHI [grant number JP16K21346].