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Pupillometry as a Screening Tool to Detect Pseudoexfoliation Syndrome
Erdogan Yasar1, Nilgun Yildirim, Eray Atalay
1*MD Aksaray University Training and Research Hospital, Aksaray (EY); Eskisehir Osmangazi University Medical School, Eskisehir (NY, EC); Derindere Hospital, Istanbul (EA); and Bilecik State Hospital, Bilecik, Turkey (ET).
Summary
Handheld pupillometry showed low diagnostic value for detecting pseudoexfoliation syndrome (PXS). Pupil asymmetry was a better indicator, increasing PXS likelihood, but overall detection accuracy remained poor.
Area of Science:
- Ophthalmology
- Diagnostic Imaging
- Ocular Diagnostics
Background:
- Pseudoexfoliation syndrome (PXS) is a common cause of secondary glaucoma.
- Accurate and early diagnosis of PXS is crucial for effective management and preventing vision loss.
- Current diagnostic methods may be time-consuming or require specialized equipment.
Purpose of the Study:
- To evaluate the diagnostic utility of a handheld pupillometer in distinguishing between eyes with pseudoexfoliation syndrome (PXS) and healthy controls.
- To assess the effectiveness of pupillometry in identifying PXS based on pupil diameter and asymmetry.
Main Methods:
- A population-based, cross-sectional study was conducted in Turkey with subjects aged 40 and older.
- Participants underwent ophthalmic examination, handheld pupillometry under standard lighting, and anterior segment imaging for PXS confirmation.
- An inter-eye pupil diameter difference of ≥0.4 mm was defined as pupil asymmetry.
Main Results:
- The study included 60 PXS subjects and 529 age-matched healthy controls.
- Mean pupil diameters did not significantly differ between PXS and control groups (P = .652).
- Receiver operating characteristic (ROC) analysis showed low precision for pupil diameter in discriminating PXS (AUC 0.56), with 14% sensitivity and 94% specificity. Pupil asymmetry increased PXS odds by 3.46-fold.
Conclusions:
- Handheld pupillometry demonstrated poor performance in detecting PXS, with a low positive predictive value of 26%.
- While pupil asymmetry showed some association with PXS, pupillometry alone is not a reliable diagnostic tool for this condition.
