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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Blue Multifocal Pupillographic Objective Perimetry in Glaucoma.

Corinne F Carle1, Andrew C James1, Maria Kolic1

  • 1John Curtin School of Medical Research The Australian National University, Canberra, Australia.

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|October 8, 2015
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Summary

Blue and yellow stimuli in multifocal pupillographic objective perimetry (mfPOP) showed similar diagnostic accuracy for moderate to severe glaucoma. Blue stimuli may offer advantages for detecting early glaucoma.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Retinal Cell Biology

Background:

  • Glaucoma diagnosis relies on detecting vision loss.
  • Melanopsin retinal ganglion cells (ipRGCs) offer a potential new target for glaucoma detection.
  • Multifocal pupillographic objective perimetry (mfPOP) can assess ipRGC function.

Purpose of the Study:

  • Compare diagnostic potential of mfPOP stimuli targeting ipRGCs.
  • Investigate stimuli biased toward cone or melanopsin input.
  • Evaluate mfPOP for glaucoma detection using different stimuli.

Main Methods:

  • Tested 19 glaucoma patients and 24 normal subjects with mfPOP.
  • Used 33-ms yellow and 750-ms blue mfPOP stimuli.
  • Assessed color discrimination and pupillary responses; analyzed diagnostic accuracy using ROC analysis.

Main Results:

  • Blue mfPOP stimuli showed larger, more variable pupil response reduction in moderate to severe glaucoma compared to yellow.
  • Color discrimination declined with age and glaucoma, with blue-yellow anomalies.
  • Receiver operating characteristic (ROC) analysis showed similar diagnostic accuracies for moderate to severe glaucoma (blue: 81.7%, yellow: 83.7%).

Conclusions:

  • Yellow and blue mfPOP stimuli had similar diagnostic accuracy in moderate to severe glaucoma.
  • Blue stimuli had limited ability to resolve scotomas in advanced disease.
  • Blue mfPOP stimuli may improve early glaucoma detection compared to yellow stimuli.