Original articleDevelopment and Validation of an Associative Model for the Detection of Glaucoma Using Pupillography
Section snippets
Subjects and Eye Examinations
In this prospective case-control study, we enrolled a total of 243 participants, including 165 patients with glaucoma and 78 normal subjects. All participants were enrolled between March 2011 and June 2012. To be eligible for participation, participants had to be 40 years old or older at enrollment, to have presenting visual acuity better than 20/100 in both eyes, and to have not had ocular surgery within 3 months. All subjects provided informed consent to participate in the study, and the
Results
A total of 236 eligible participants were enrolled in our study, and 219 (93%) of them completed the pupillographic examination. Of the 17 incomplete examinations, 4 were due to frequent blinking, 3 were due to software errors, and the pupil waveforms of the other 10 were unanalyzable. Among the 219 subjects who successfully completed the pupillographic test, 148 cases had glaucoma in at least 1 eye (93% primary open-angle glaucoma, 3% primary angle-closure glaucoma, and 4% secondary glaucoma),
Discussion
The asymmetry of the pupillary light reflex between eyes (a surrogate for an RAPD) differed significantly when comparing patients with glaucoma to those without evidence of retinal or optic nerve disease. However, nearly half of those with glaucoma were missed when comparing only the between-eye responses. Noting this limitation, we compared the pupil responses for corresponding superonasal vs inferonasal fields and observed greater within-eye asymmetry in patients who did not have an RAPD.
Dolly S. Chang, MD, MPH, PhD, received her medical degree from National Taiwan University and subsequently earned her MPH and PhD in epidemiology from Johns Hopkins University Bloomberg School of Public Health. Her areas of research interest include the screening, prevention, and interventions of eye diseases, the methodology and conduct of clinical trials and systematic reviews, and pupil pathophysiology.
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Dolly S. Chang, MD, MPH, PhD, received her medical degree from National Taiwan University and subsequently earned her MPH and PhD in epidemiology from Johns Hopkins University Bloomberg School of Public Health. Her areas of research interest include the screening, prevention, and interventions of eye diseases, the methodology and conduct of clinical trials and systematic reviews, and pupil pathophysiology.
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