Melanopsin mediated post-illumination pupil response in early age-related macular degeneration

Maynard, Michelle L., Zele, Andrew J., & Feigl, Beatrix (2015) Melanopsin mediated post-illumination pupil response in early age-related macular degeneration. Investigative Ophthalmology and Visual Science, 56, pp. 6906-6913.

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Abstract

Purpose

To determine whether melanopsin expressing intrinsically photosensitive Retinal Ganglion Cell (ipRGC) inputs to the pupil light reflex (PLR) are affected in early age-related macular degeneration (AMD).

Methods

The PLR was measured in 40 participants (20 early AMD and 20 age-matched controls) using a custom-built Maxwellian-view pupillometer. Sinusoidal stimuli (0.5 Hz, 11.9 s duration, 35.6° diameter) were presented to the study eye and the consensual pupil response was measured for stimuli with high melanopsin excitation (464nm; blue) and with low melanopsin excitation (638 nm; red) that biased activation to the outer retina. Two melanopsin PLR metrics were quantified: the Phase Amplitude Percentage (PAP) during the sinusoidal stimulus presentation and the Post-Illumination Pupil Response (PIPR). The PLR during stimulus presentation was analyzed using latency to constriction, transient pupil response and maximum pupil constriction metrics. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curves.

Results

The blue PIPR was significantly less sustained in the early AMD group (p<0.001). The red PIPR was not significantly different between groups (p>0.05). The PAP and blue stimulus constriction amplitude were significantly lower in the early AMD group (p < 0.05). There was no significant difference between groups in the latency or transient amplitude for both stimuli (p>0.05). ROC analysis showed excellent diagnostic accuracy for the blue PIPR metrics (AUC>0.9).

Conclusions

This is the initial report that the melanopsin controlled PIPR is dysfunctional in early AMD. The non-invasive, objective measurement of the ipRGC controlled PIPR has excellent diagnostic accuracy for early AMD.

Impact and interest:

4 citations in Scopus
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3 citations in Web of Science®

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ID Code: 90217
Item Type: Journal Article
Refereed: Yes
Keywords: intrinsically photosensitive Retinal Ganglion Cells (ipRGCs), melanopsin, pupil light reflex, post-illumination pupil response
DOI: 10.1167/iovs.15-17357
ISSN: 1552-5783
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Funding:
Copyright Owner: Copyright 2015 Association for Research in Vision and Ophthalmology
Deposited On: 15 Nov 2015 23:29
Last Modified: 22 Nov 2015 06:05

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