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Automated Pupillometry Using a Prototype Binocular Optical Coherence Tomography System
Reena Chopra1, Pádraig J Mulholland2, Axel Petzold3
1National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom.
A new binocular optical coherence tomography (OCT) prototype shows excellent test-retest reliability for pupillometry measurements. However, its diagnostic accuracy for relative afferent pupillary defects (RAPDs) was lower than a standard infrared pupillometer.
Area of Science:
- Ophthalmology
- Medical Devices
- Diagnostic Technology
Background:
- Relative afferent pupillary defect (RAPD) assessment is crucial for diagnosing optic nerve and retinal diseases.
- Current methods for pupillometry, including RAPD detection, vary in reliability and objectivity.
- Automated pupillometry offers potential for more consistent and accurate measurements.
Purpose of the Study:
- To evaluate the test-retest reliability of a novel binocular optical coherence tomography (OCT) system for pupillometry.
- To determine the diagnostic accuracy of this binocular OCT prototype in detecting relative afferent pupillary defects (RAPDs).
- To compare the performance of the binocular OCT system against a established automated infrared pupillometer (RAPDx).
Main Methods:
- Fifty participants with confirmed RAPDs and 50 healthy controls underwent two pupillometry examinations using the binocular OCT system.
- Pupil parameters (maximum/minimum diameter, anisocoria) were measured, and RAPD magnitude was calculated.
- A single examination was performed using the RAPDx device for comparison.
Main Results:
- The binocular OCT system demonstrated excellent test-retest reliability for pupil diameter and anisocoria measurements (Intraclass Correlation Coefficient >0.90).
- The RAPDx device achieved a sensitivity of 82% and specificity of 94% for RAPD detection.
- The binocular OCT prototype showed a sensitivity of 74% and specificity of 86%, with a diagnostic accuracy of 80%.
Conclusions:
- Binocular OCT-derived pupillometry exhibits high test-retest reliability.
- The diagnostic accuracy of the binocular OCT for RAPD detection was found to be inferior to the RAPDx.
- Future integration of OCT into routine eye exams could offer efficient objective pupillary response quantification, pending improvements in accuracy.
