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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.

American Journal of Ophthalmology
|March 2, 2020
PubMed
Summary
This summary is machine-generated.

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.

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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.