Pupil size and Perimetry—a pharmacological model using increment and decrement stimuli

Abstract

To assess the influence of natural and pharmacologically induced pupil size fluctuations on differential luminance sensitivity threshold (DLS) using bright (increment) and dark (decrement) stimuli. Twelve healthy volunteers (20-30 years) were examined under the effect of phenylephrine 2%, dapiprazole 0.5%, and placebo. Pupil size was recorded by infra-red video camera in sessions without and with visual field examination (Tübingen Computer Campimeter). DLS was estimated at 9 locations within the central 20 degrees visual field, using bright and dark 26 min-of-arc-stimuli (10 cd/m(2) background, 4-2-1 dB thresholding strategy, four reversals). There were substantial inter-individual differences in pupil size and pupil size fluctuations. Intra-individual differences were small. Independently of medication, pupil size fluctuations were reduced by more than one-third when a subject was undergoing perimetric examination. Pupil size affected DLS on its own (slope 0.21 dB/mm; 95% CI: 0.09-0.33 dB/mm), differently at different stimulus locations, and to a greater extent with increment than with decrement stimuli (slope difference 0.13 dB/mm; 95% CI: 0.00-0.26 dB/mm). Campimetric examinations have a stabilising effect on pupil size fluctuations. Pupil size affects DLS with bright stimuli more than with dark stimuli; in normal young subjects this effect is not relevant for clinical or normative studies.