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Recovery dynamics of multifocal pupillographic objective perimetry from tropicamide dilation

  • Bhim Bahadur RaiEmail author
  • Faran Sabeti
  • Corinne F. Carle
  • Emilie M. F. Rohan
  • Özge Saraç
  • Joshua van Kleef
  • Ted Maddess
Neurophthalmology
  • 36 Downloads

Abstract

Purpose

To study the pupillary system by combining mydriasis and multifocal pupillographic objective perimetry (mfPOP). In particular, we explored how the dynamics of recovery differ for concurrently measured direct and consensual sensitivity, response delay, and signal-to-noise ratios (SNRs) for binocular mydriasis.

Methods

We recruited 26 normal participants, all with brown irides. The dichoptic mfPOP stimuli concurrently assessed 44-region/eye and both pupils. Two pre-dilation tests were followed by pairs of repeated tests at 1, 2, 4, 6, 8, 12, 24, and 48 h following dilation of both pupils with 1% tropicamide. Three subjects were retested with only the right pupil dilated. Linear models determined the independent effects of mydriasis upon the per-region and pupil measures over time.

Results

Post-dilation, the per-region delays initially decreased by 16.3 ± 6.02 ms (mean ± SE) (p < 0.0001, cf. baseline of 471.1 ± 4.36 ms), then increased to slower than baseline by 17.42 ± 5.57 ms after 4 h (p < 0.002), recovering to baseline at 8 h. By comparison, per-region sensitivities (constriction amplitudes) were still reduced by − 6.20 ± 0.70 μm at 8 h (p < 0.0001, cf. baseline of 21.1 ± 0.55 μm), recovered at 24 h, but rebounded at 48 h (p = 0.005). The SNRs for sensitivities and delays both recovered by 8–12 h. Across all the data, sensitivities reduced by 2.67 ± 0.25 μm/decade of age, and delay increased by 15.4 ± 1.98 ms/decade (both p < 0.00001). Data from 3 of the 26 subjects who repeated the testing for monocular dilation found that consensual response sensitivities were larger than direct for 8 h (p < 0.018).

Conclusions

The per-region sensitivities were affected for longer than SNRs or delays. Strong early SNRs indicated proportionately lower pupil noise for larger pupil diameters. Following mydriasis with tropicamide 1%, the constriction amplitude measurements with mfPOP should be considered only after 48 h, but time-to-peak can be measured after 8–12 h.

Keywords

Anisocoria Multifocal Objective perimetry Pupillography Rebound miosis Tropicamide 

Notes

Funding information

This research was supported by the Australian Research Council through the ARC Centre of Excellence in Vision Science (CE0561903), intramural funding from the ANU, and an ANU PhD scholarship to BB Rai.

Compliance with ethical standards

Conflict of interest

Authors FS, CFC, JvK, and TM could possibly receive royalty income from patents assigned to Konan Medical USA Inc. for a possible product based upon the mfPOP methods. The other authors declare that they have no conflict of interest.

Ethical approval and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Australian National University and ACT Health and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Neuroscience, John Curtin School of Medical ResearchAustralian National UniversityCanberraAustralia
  2. 2.School of OptometryUniversity of CanberraBruceAustralia
  3. 3.ANU Medical SchoolANUCanberraAustralia
  4. 4.Department of Ophthalmology, Ankara Atatürk Training and Research HospitalYildirim Beyazit UniversityAnkaraTurkey

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