Abstract
Chromatic pupillometry is an emerging method for evaluating ocular health that relies upon the differential stimulation of rods, cones, and intrinsically photosensitive retinal ganglion cells (ipRGCs). Although it has been investigated in conditions affecting the outer or inner retina, there is a paucity of studies in conditions where the anterior chamber of the eye is affected. Primary angle closure suspects (PACS) are defined as eyes with narrow anterior chamber angles and intact retina. PACS patients are at risk of developing primary angle closure glaucoma and are prophylactically treated by performing laser peripheral iridotomy (LPI). Here we evaluated pupillary responses to monchromatic lights in 18 PACS before and after LPI, and compared the results with those of 36 age-matched controls who had gonioscopically open angles. Dose response curves for pupillary constriction were similar between PACS patients and controls (p = 0.98 for blue and 0.90 for red light) and within subjects pre- and post-LPI (p = 0.58 for blue and 0.20 for red light). Baseline-adjusted pupillary constriction responses to blue and red lights were similar in controls and PACS, and not altered after LPI. Our findings suggest that narrow irido-corneal angles and LPI do not influence pupillary responses in PACS.
Highlights
Pupillary responses to light are dependent on the integrity of the retina as well as intact afferent and efferent neural pathways[1,2,3]
The main finding in our study is that the baseline-adjusted pupillary constriction profiles in Primary angle closure suspect (PACS) patients are not different from those of control subjects, indicating that anterior segment morphology itself does not alter light induced pupillary constriction responses
The constriction profiles remain unaltered in PACS following laser peripheral iridotomy (LPI), despite a significant reduction in baseline pupil diameter
Summary
Pupillary responses to light are dependent on the integrity of the retina as well as intact afferent and efferent neural pathways[1,2,3]. Primary angle closure suspect (PACS) eyes are defined as eyes with occludable anterior chamber angles, without peripheral anterior synechiae (PAS) or raised intra ocular pressure (IOP), and associated with normal optic discs and normal visual fields[11]. These eyes are said to have narrow irido-corneal angles and at risk for developing primary angle closure glaucoma (PACG)[12, 13], which is an important cause of ocular morbidity in Asia, especially with the rapidly ageing population[14]. We assessed whether LPI alters chromatic pupillometry parameters in PACS through mechanical changes in the iris
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