Multifocal pupillography identifies changes in visual sensitivity according to severity of diabetic retinopathy in type 2 diabetes

Faran Sabeti, Chris J. Nolan, Andrew C. James, Alicia Jenkins, Ted Maddess

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

PURPOSE. Retinal light sensitivity loss has been shown to occur prior to other signs of retinopathy and may predict the sight-threatening sequelae. A rapid, objective perimetric test could augment diabetes care. We investigated the clinical use of multifocal pupillographic objective perimetry (mfPOP) to identify patients with and without diabetic retinopathy. METHODS. Retinopathy severity was determined using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard for fundus photography. Pupillary responses were measured from both eyes of 25 adults with none to moderate diabetic retinopathy and 24 agematched controls, using three mfPOP stimulus variants. Multifocal pupillographic objective perimetry stimulus variants tested 44 regions per eye arranged in a five-ring dartboard layout presented within either the central 300 or 600 of fixation. Receiver operator characteristic (ROC) curves were produced from contraction amplitudes and time to peak responses. RESULTS. Regression analysis revealed that mean amplitude deviations were larger with severity of early retinopathy. On average, the longest delays were measured in patients with no retinopathy. The brightest wide-field stimuli produced the highest area under the ROC curve for differentiating eyes with no retinopathy from nonproliferative diabetic retinopathy (NPDR) and from healthy eyes (100 ± 0.0%, mean ± SE). The asymmetry in local delay deviations between eyes tended to produce higher sensitivity and specificity than amplitude deviations. CONCLUSIONS. Asymmetry in local response delays measured by mfPOP may provide useful information regarding the severity of diabetic retinopathy and may have clinical use as a rapid, noninvasive method for identifying functional loss even in the absence of NPDR.

Original languageEnglish
Pages (from-to)4504-4513
Number of pages10
JournalInvestigative Ophthalmology and Visual Science
Volume56
Issue number8
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

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Diabetic Retinopathy
Type 2 Diabetes Mellitus
Visual Field Tests
Photophobia
Photography
Regression Analysis
Sensitivity and Specificity

Cite this

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title = "Multifocal pupillography identifies changes in visual sensitivity according to severity of diabetic retinopathy in type 2 diabetes",
abstract = "PURPOSE. Retinal light sensitivity loss has been shown to occur prior to other signs of retinopathy and may predict the sight-threatening sequelae. A rapid, objective perimetric test could augment diabetes care. We investigated the clinical use of multifocal pupillographic objective perimetry (mfPOP) to identify patients with and without diabetic retinopathy. METHODS. Retinopathy severity was determined using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard for fundus photography. Pupillary responses were measured from both eyes of 25 adults with none to moderate diabetic retinopathy and 24 agematched controls, using three mfPOP stimulus variants. Multifocal pupillographic objective perimetry stimulus variants tested 44 regions per eye arranged in a five-ring dartboard layout presented within either the central 300 or 600 of fixation. Receiver operator characteristic (ROC) curves were produced from contraction amplitudes and time to peak responses. RESULTS. Regression analysis revealed that mean amplitude deviations were larger with severity of early retinopathy. On average, the longest delays were measured in patients with no retinopathy. The brightest wide-field stimuli produced the highest area under the ROC curve for differentiating eyes with no retinopathy from nonproliferative diabetic retinopathy (NPDR) and from healthy eyes (100 ± 0.0{\%}, mean ± SE). The asymmetry in local delay deviations between eyes tended to produce higher sensitivity and specificity than amplitude deviations. CONCLUSIONS. Asymmetry in local response delays measured by mfPOP may provide useful information regarding the severity of diabetic retinopathy and may have clinical use as a rapid, noninvasive method for identifying functional loss even in the absence of NPDR.",
keywords = "Diabetic retinopathy, Multifocal, Objective perimetry, Pupils, Type 2 diabetes",
author = "Faran Sabeti and Nolan, {Chris J.} and James, {Andrew C.} and Alicia Jenkins and Ted Maddess",
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Multifocal pupillography identifies changes in visual sensitivity according to severity of diabetic retinopathy in type 2 diabetes. / Sabeti, Faran; Nolan, Chris J.; James, Andrew C.; Jenkins, Alicia; Maddess, Ted.

In: Investigative Ophthalmology and Visual Science, Vol. 56, No. 8, 01.01.2015, p. 4504-4513.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multifocal pupillography identifies changes in visual sensitivity according to severity of diabetic retinopathy in type 2 diabetes

AU - Sabeti, Faran

AU - Nolan, Chris J.

AU - James, Andrew C.

AU - Jenkins, Alicia

AU - Maddess, Ted

PY - 2015/1/1

Y1 - 2015/1/1

N2 - PURPOSE. Retinal light sensitivity loss has been shown to occur prior to other signs of retinopathy and may predict the sight-threatening sequelae. A rapid, objective perimetric test could augment diabetes care. We investigated the clinical use of multifocal pupillographic objective perimetry (mfPOP) to identify patients with and without diabetic retinopathy. METHODS. Retinopathy severity was determined using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard for fundus photography. Pupillary responses were measured from both eyes of 25 adults with none to moderate diabetic retinopathy and 24 agematched controls, using three mfPOP stimulus variants. Multifocal pupillographic objective perimetry stimulus variants tested 44 regions per eye arranged in a five-ring dartboard layout presented within either the central 300 or 600 of fixation. Receiver operator characteristic (ROC) curves were produced from contraction amplitudes and time to peak responses. RESULTS. Regression analysis revealed that mean amplitude deviations were larger with severity of early retinopathy. On average, the longest delays were measured in patients with no retinopathy. The brightest wide-field stimuli produced the highest area under the ROC curve for differentiating eyes with no retinopathy from nonproliferative diabetic retinopathy (NPDR) and from healthy eyes (100 ± 0.0%, mean ± SE). The asymmetry in local delay deviations between eyes tended to produce higher sensitivity and specificity than amplitude deviations. CONCLUSIONS. Asymmetry in local response delays measured by mfPOP may provide useful information regarding the severity of diabetic retinopathy and may have clinical use as a rapid, noninvasive method for identifying functional loss even in the absence of NPDR.

AB - PURPOSE. Retinal light sensitivity loss has been shown to occur prior to other signs of retinopathy and may predict the sight-threatening sequelae. A rapid, objective perimetric test could augment diabetes care. We investigated the clinical use of multifocal pupillographic objective perimetry (mfPOP) to identify patients with and without diabetic retinopathy. METHODS. Retinopathy severity was determined using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard for fundus photography. Pupillary responses were measured from both eyes of 25 adults with none to moderate diabetic retinopathy and 24 agematched controls, using three mfPOP stimulus variants. Multifocal pupillographic objective perimetry stimulus variants tested 44 regions per eye arranged in a five-ring dartboard layout presented within either the central 300 or 600 of fixation. Receiver operator characteristic (ROC) curves were produced from contraction amplitudes and time to peak responses. RESULTS. Regression analysis revealed that mean amplitude deviations were larger with severity of early retinopathy. On average, the longest delays were measured in patients with no retinopathy. The brightest wide-field stimuli produced the highest area under the ROC curve for differentiating eyes with no retinopathy from nonproliferative diabetic retinopathy (NPDR) and from healthy eyes (100 ± 0.0%, mean ± SE). The asymmetry in local delay deviations between eyes tended to produce higher sensitivity and specificity than amplitude deviations. CONCLUSIONS. Asymmetry in local response delays measured by mfPOP may provide useful information regarding the severity of diabetic retinopathy and may have clinical use as a rapid, noninvasive method for identifying functional loss even in the absence of NPDR.

KW - Diabetic retinopathy

KW - Multifocal

KW - Objective perimetry

KW - Pupils

KW - Type 2 diabetes

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U2 - 10.1167/iovs.15-16712

DO - 10.1167/iovs.15-16712

M3 - Article

VL - 56

SP - 4504

EP - 4513

JO - Investigative Ophthalmology

JF - Investigative Ophthalmology

SN - 0146-0404

IS - 8

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