MODIFICATION OF THE NEUROPTICS PUPILLOMETER TO MEASURE NEAR RESPONSE MIOSIS IN CATARACTOUS AND PSEUDOPHAKIC SUBJECTS

Title MODIFICATION OF THE NEUROPTICS PUPILLOMETER TO MEASURE NEAR RESPONSE MIOSIS IN CATARACTOUS AND PSEUDOPHAKIC SUBJECTS
Author, Co-Author George Zikos, Rocco Robilotto, Steven Ali, Arkady Selenow, Mike Morris, Amitava Gupta
Topic
Year
2013
Day
Program Number
135435
Room
Room 6C
Affiliation
Institute for Vision Research, MVA
Abstract PURPOSE: We have developed a tool to quickly measure the change in pupil diameter to a change in accommodative stimulus for the purpose of testing cataractous and pseudophakic subjects whose near pupillary response has been questioned.

METHODS: This study examined the pupillary near response using an infrared pupillometer (NeurOptics PLR-200) modified with a detachable near target. The right eye of 230 subjects (mean age = 70.9 ± 5.7 years, range 60.0 - 80.8  years) was measured for 5 seconds at 32 fps while the left eye viewed either a distant target at 3 meters or a near target at 30 cm under normal room illumination. Exclusion criteria included medical diagnoses or use of medications known to affect pupil function. Of the 230 subjects, 68 had a diagnosis of cataracts, while 162 had a history of bilateral cataract surgery with monofocal PCIOL at least 3 months prior. 33 of the cataractous subjects had bilateral cataract surgery during the study period and were tested post surgically as well.

RESULTS: Mean distance pupil = 4.33 ± 0.77mm and mean near = 4.10 ± 0.76mm (paired t-test p<0.001). 71% of subjects had measurable near response miosis. A linear regression fit found a weak correlation between near pupil miosis and age (slope = -0.008, R2 of 0.021). Among the cataractous subgroup, mean distance pupil = 4.42 ± 0.70mm and near = 4.12 ± 0.72mm (paired t-test p<0.001). 78% of subjects had measurable near response. Age had a stronger effect on near miosis (slope  = -0.018, R2 = 0.125). Among the pseudophakic subgroup, mean distance pupil = 4.25 ± 0.76mm and near = 4.04 ± 0.77mm (paired t-test p<0.001). 70% of subjects had measurable near response. Age had almost no effect on near miosis (slope = -0.002, R2 = 0.001).

CONCLUSIONS: We have demonstrated that with the modification of a simple clinical device, near pupillary response changes can be measured in cataractous and pseudophakic subjects.
Affiliation of Co-Authors Institute for Vision Research, MVA, Institute for Vision Research, MVA, Institute for Vision Research, MVA, Elenza, Inc, Elenza, Inc
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