• Written By: John T. Lind, MD

    Investigators developed and validated a model that uses pupillography to discriminate between people with and without glaucoma.

    Using a prototype pupillometer designed to record and analyze pupillary responses at multiple, controlled stimulus intensities while using varied stimulus patterns and colors, they evaluated 148 patients with glaucoma (mean age 67 ± 11 years) and 71 controls (mean age 60 ± 10 years) in a clinical setting.

    They used three approaches: (1) comparing the responses between the two eyes; (2) comparing responses to stimuli between the superonasal and inferonasal fields within each eye; and (3) calculating the absolute pupil response of each individual eye.

    Patients with glaucoma had more asymmetric pupil responses in the two eyes (P < 0.001) and between superonasal and inferonasal visual fields within the same eye (P = 0.014). They also showed smaller amplitudes, slower velocities and longer latencies of pupil responses compared to controls (all P < 0.001).

    An associative model incorporating these findings  resulted in an area-under-the-receiver operating characteristic curve of 0.87 (95% CI 0.83 to 0.92) with 80 percent sensitivity and specificity in detecting glaucoma. T

    They conclude that pupillography may provide a simple and inexpensive approach to glaucoma screening, but additional study is warranted to validate these findings in a community-based population and to determine whether further refinements can be made to improve performance of the model.