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Dichoptic multifocal pupillography reveals afferent visual field defects in early type 2 diabetes

Bell, James Andrew; James, Andrew; Kolic, Maria; Essex, Rohan; Maddess, Ted

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PURPOSE. Multifocal pupillographic perimetry was used to examine differences in the visual fields of 23 subjects with early type 2 diabetes (T2D) and 23 age- and sex-matched control subjects. METHODS. Independent stimuli were delivered to 44 regions of each eye while pupil responses were recorded with infrared cameras. The stimuli were presented in 8 segments of 30 seconds, and both eyes of each subject were tested twice. The direct and consensual responses provided 88 responses per eye. The...[Show more]

dc.contributor.authorBell, James Andrew
dc.contributor.authorJames, Andrew
dc.contributor.authorKolic, Maria
dc.contributor.authorEssex, Rohan
dc.contributor.authorMaddess, Ted
dc.date.accessioned2015-12-10T23:06:32Z
dc.identifier.issn1552-5783
dc.identifier.urihttp://hdl.handle.net/1885/62698
dc.description.abstractPURPOSE. Multifocal pupillographic perimetry was used to examine differences in the visual fields of 23 subjects with early type 2 diabetes (T2D) and 23 age- and sex-matched control subjects. METHODS. Independent stimuli were delivered to 44 regions of each eye while pupil responses were recorded with infrared cameras. The stimuli were presented in 8 segments of 30 seconds, and both eyes of each subject were tested twice. The direct and consensual responses provided 88 responses per eye. The diagnostic power of the method was then examined by applying receiver operator analysis to the peak regional contraction amplitudes, time to peaks, and linear combinations of those. RESULTS. Dichoptic multifocal pupillography provided response amplitudes with a median z-score of 2.63 ± 0.26 (SE). The diagnostic performance (expressed as areas under ROC plots) of the eight subjects (32 fields) who had had T2D for at least 10 years was 0.87 ± 0.06 (mean ± SE) for response amplitude deviations from normative data, rising to 0.95 ± 0.04 when between-eye symmetry was considered. Mean pupil size did not have diagnostic power. Comparison of direct and consensual response fields indicated that the observed localized field defects were afferent. CONCLUSIONS. Reasonable diagnostic power was obtained, especially for the 16 eyes that had had T2D for more than 10 years, inferring that even in the near absence of visible diabetic retinopathy, some retinal damage had been sustained. This result, if confirmed in a wider group, suggests the that the method may be clinically useful in screening for early damage to the retina in T2D diabetes.
dc.publisherAssociation for Research in Vision and Opthalmology
dc.sourceInvestigative Ophthalmology and Visual Science
dc.subjectKeywords: adult; article; clinical article; controlled study; diagnostic test accuracy study; diagnostic value; dichoptic multifocal pupillography; female; human; male; non insulin dependent diabetes mellitus; priority journal; pupil reflex; pupillography; receiver
dc.titleDichoptic multifocal pupillography reveals afferent visual field defects in early type 2 diabetes
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume51
dc.date.issued2010
local.identifier.absfor111301 - Ophthalmology
local.identifier.ariespublicationu9204316xPUB726
local.type.statusPublished Version
local.contributor.affiliationBell, James Andrew, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationJames, Andrew, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationKolic, Maria, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationEssex, Rohan, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMaddess, Ted, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.startpage602
local.bibliographicCitation.lastpage608
local.identifier.doi10.1167/iovs.09-3659
dc.date.updated2016-02-24T11:53:44Z
local.identifier.scopusID2-s2.0-75749132487
local.identifier.thomsonID000273264200079
CollectionsANU Research Publications

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