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Pupillary response in adults with Marfan syndrome and its effect on straylight
Gunhild Falleth Sandvik1,2, Svend Rand-Hendriksen2,3, Liv Drolsum1,2
1Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
Purpose:
The main objective of this study was to examine the pupillary response in patients with Marfan syndrome (MFS) and secondarily to determine whether changes in the pupillary response are associated with the increased disability glare previously shown in the same patient population.
Methods:
This study included 60 eyes of 34 patients with MFS diagnosed in accordance with the Ghent-2 criteria and 81 eyes of 44 controls. Pupillary response was measured with a pupillograph and disability glare with a straylight meter.
Results:
The patients with MFS had a significantly smaller maximum pupil size than the control group, 4.87 (4.50-5.23) mm versus 5.58 (5.25-5.90) mm (p = 0.01). In addition, they exhibited slower contraction velocities (p = 0.03) and longer re-dilation times (p = 0.01) compared with the control group. The mean straylight value was higher in patients with MFS than controls, even when including pupillary parameters together with lens surgery, cataract, iris colour, axial length and corneal curvature as possible explanatory variables in the analysis. However, when including data from both groups, a significant negative correlation was seen between maximum pupillary diameter and straylight value (p = 0.01). The other pupillary parameters did not correlate with straylight.
Conclusion:
Patients with MFS had a smaller maximum pupil diameter, slower pupillary contraction and longer re-dilation time than the controls. Despite the correlation between pupil size and straylight value, the pupillary response demonstrated in MFS eyes could not explain the increased straylight in these patients.
Insights
Patients with Marfan syndrome (MFS) exhibit altered pupillary responses, including smaller pupil size and slower contraction. These changes, however, do not fully explain the increased disability glare observed in MFS patients.
Area of Science:
- Ophthalmology
- Genetics
- Physiology
Background:
- Marfan syndrome (MFS) is a genetic disorder affecting connective tissue.
- Previous studies indicate increased disability glare in patients with MFS.
- The pupillary response in MFS patients has not been extensively studied in relation to glare.
Purpose of the Study:
- To investigate pupillary responses in individuals with Marfan syndrome (MFS).
- To determine if altered pupillary responses correlate with increased disability glare in MFS patients.
Main Methods:
- Compared pupillary responses (size, contraction, re-dilation) in 34 MFS patients and 44 controls using a pupillograph.
- Measured disability glare using a straylight meter.
- Analyzed data considering factors like lens surgery, cataract, and axial length.
Main Results:
- MFS patients showed significantly smaller maximum pupil size (4.87 mm vs. 5.58 mm) compared to controls.
- Pupillary contraction velocity was slower and re-dilation time was longer in MFS patients (p < 0.05).
- While a correlation between pupil size and straylight was found, pupillary parameters did not fully explain the increased straylight in MFS.
Conclusions:
- Patients with Marfan syndrome exhibit distinct pupillary abnormalities, including reduced maximum pupil diameter and slower dynamics.
- The observed pupillary response characteristics in MFS do not account for the heightened disability glare reported in this population.
- Further research is needed to elucidate the mechanisms behind increased straylight in Marfan syndrome.
