Quadrant field pupillometry detects melanopsin dysfunction in glaucoma suspects and early glaucoma

Adhikari, Prakash, Zele, Andrew J., Thomas, Ravi, & Feigl, Beatrix (2016) Quadrant field pupillometry detects melanopsin dysfunction in glaucoma suspects and early glaucoma. Scientific Reports, 6, Article Number-33373.

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It is difficult to detect visual function deficits in patients at risk for glaucoma (glaucoma suspects) and at early disease stages with conventional ophthalmic tests such as perimetry. To this end, we introduce a novel quadrant field measure of the melanopsin retinal ganglion cell mediated pupil light response corresponding with typical glaucomatous arcuate visual field defects. The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 46 patients with different stages of glaucoma including glaucoma suspects and compared to a healthy group of 21 participants with no disease. We demonstrate that the superonasal quadrant PIPR differentiated glaucoma suspects and early glaucoma patients from controls with fair (AUC = 0.74) and excellent (AUC = 0.94) diagnostic accuracy, respectively. The superonasal PIPR provides a linear functional correlate of structural retinal nerve fibre thinning in glaucoma suspects and early glaucoma patients. This first report that quadrant PIPR stimulation detects melanopsin dysfunction in patients with early glaucoma and at pre-perimetric stages may have future implications in treatment decisions of glaucoma suspects.

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ID Code: 99614
Item Type: Journal Article
Refereed: Yes
Keywords: melanopsin, intrinsically photosensitive Retinal Ganglion cells, glaucoma, pupil light reflex
DOI: 10.1038/srep33373
ISSN: 2045-2322
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
Copyright Owner: Copyright 2016 The Author(s)
Copyright Statement: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Deposited On: 29 Sep 2016 23:08
Last Modified: 04 Oct 2016 19:29

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