Carina Kelbsch1, Fumiatsu Maeda2,3, Torsten Strasser2,4, Gunnar Blumenstock5, Barbara Wilhelm2, Helmut Wilhelm2, Tobias Peters2. 1. Pupil Research Group at the Centre for Ophthalmology, University of Tuebingen, Schleichstraße 12, 72076, Tuebingen, Germany. carina.kelbsch@med.uni-tuebingen.de. 2. Pupil Research Group at the Centre for Ophthalmology, University of Tuebingen, Schleichstraße 12, 72076, Tuebingen, Germany. 3. Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan. 4. Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany. 5. Department of Clinical Epidemiology and Applied Biometry, University of Tuebingen, Tuebingen, Germany.
Abstract
PURPOSE: The aim was to investigate the involvement of intrinsically photosensitive retinal ganglion cells (ipRGCs) in patients with manifest glaucoma and ocular hypertension (OH) using specific parameters of the pupil light reflex to chromatic stimuli. METHODS: Twenty-five patients with manifest glaucoma, 16 patients with OH and 16 healthy control subjects were stimulated with 28 lx red (605 nm) or blue (420 nm) light with a duration of either 1 s or 4 s. The consensual pupil light reaction was recorded by means of infrared pupillometry. The maximal relative amplitude (MRA), the post-illumination pupil response PIPRblue-red, and the slope of the response during exposure to the 4 s red stimulus (SORRS) were calculated and compared using ANOVA and Tukey-Kramer post-hoc tests. Correlations between pupil parameters and visual field defects were analyzed using Pearson correlation coefficient r. RESULTS: PIPRblue-red was reduced in glaucoma patients compared to normals (p < 0.001) and OH (p < 0.01). There was no significant difference between OH and normals. Glaucoma patients showed additionally reduced MRA for red and blue light (p < 0.05) and a pupillary escape during exposure to red light (increased SORRS, p < 0.0005). This pupillary escape could also be seen in single subjects with OH. Significant correlations between pupil parameters and visual field defects were detected. CONCLUSIONS: The reduced PIPRblue-red indicates a characteristic impairment of the melanopsin-driven pathway of ipRGCs in glaucoma patients, whereas the reduced MRA and increased SORRS suggest a disturbed synaptic function and altered interaction between outer photoreceptors, RGCs, and ipRGCs.
PURPOSE: The aim was to investigate the involvement of intrinsically photosensitive retinal ganglion cells (ipRGCs) in patients with manifest glaucoma and ocular hypertension (OH) using specific parameters of the pupil light reflex to chromatic stimuli. METHODS: Twenty-five patients with manifest glaucoma, 16 patients with OH and 16 healthy control subjects were stimulated with 28 lx red (605 nm) or blue (420 nm) light with a duration of either 1 s or 4 s. The consensual pupil light reaction was recorded by means of infrared pupillometry. The maximal relative amplitude (MRA), the post-illumination pupil response PIPRblue-red, and the slope of the response during exposure to the 4 s red stimulus (SORRS) were calculated and compared using ANOVA and Tukey-Kramer post-hoc tests. Correlations between pupil parameters and visual field defects were analyzed using Pearson correlation coefficient r. RESULTS:PIPRblue-red was reduced in glaucomapatients compared to normals (p < 0.001) and OH (p < 0.01). There was no significant difference between OH and normals. Glaucomapatients showed additionally reduced MRA for red and blue light (p < 0.05) and a pupillary escape during exposure to red light (increased SORRS, p < 0.0005). This pupillary escape could also be seen in single subjects with OH. Significant correlations between pupil parameters and visual field defects were detected. CONCLUSIONS: The reduced PIPRblue-red indicates a characteristic impairment of the melanopsin-driven pathway of ipRGCs in glaucomapatients, whereas the reduced MRA and increased SORRS suggest a disturbed synaptic function and altered interaction between outer photoreceptors, RGCs, and ipRGCs.
Authors: Rachel S Li; Bai-Yu Chen; David K Tay; Henry H L Chan; Ming-Liang Pu; Kwok-Fai So Journal: Invest Ophthalmol Vis Sci Date: 2006-07 Impact factor: 4.799
Authors: Dennis M Dacey; Hsi-Wen Liao; Beth B Peterson; Farrel R Robinson; Vivianne C Smith; Joel Pokorny; King-Wai Yau; Paul D Gamlin Journal: Nature Date: 2005-02-17 Impact factor: 49.962
Authors: Timothy M Brown; Carlos Gias; Megumi Hatori; Sheena R Keding; Ma'ayan Semo; Peter J Coffey; John Gigg; Hugh D Piggins; Satchidananda Panda; Robert J Lucas Journal: PLoS Biol Date: 2010-12-07 Impact factor: 8.029
Authors: S Hattar; R J Lucas; N Mrosovsky; S Thompson; R H Douglas; M W Hankins; J Lem; M Biel; F Hofmann; R G Foster; K-W Yau Journal: Nature Date: 2003-06-15 Impact factor: 49.962
Authors: Sarah C Flanagan; Kathryn J Saunders; Hope M Queener; Patrick Richardson; Lisa A Ostrin Journal: Optom Vis Sci Date: 2020-03 Impact factor: 2.106
Authors: Jason C Park; Yi-Fan Chen; Norman P Blair; Felix Y Chau; Jennifer I Lim; Yannek I Leiderman; Mahnaz Shahidi; J Jason McAnany Journal: Sci Rep Date: 2017-03-23 Impact factor: 4.379
Authors: Carina Kelbsch; Torsten Strasser; Yanjun Chen; Beatrix Feigl; Paul D Gamlin; Randy Kardon; Tobias Peters; Kathryn A Roecklein; Stuart R Steinhauer; Elemer Szabadi; Andrew J Zele; Helmut Wilhelm; Barbara J Wilhelm Journal: Front Neurol Date: 2019-02-22 Impact factor: 4.003
Authors: Krunoslav T Stingl; Laura Kuehlewein; Nicole Weisschuh; Saskia Biskup; Frans P M Cremers; M Imran Khan; Carina Kelbsch; Tobias Peters; Marius Ueffing; Barbara Wilhelm; Eberhart Zrenner; Katarina Stingl Journal: Transl Vis Sci Technol Date: 2019-12-20 Impact factor: 3.283
Authors: Helle Østergaard Madsen; Shakoor Ba-Ali; Henrik Lund-Andersen; Klaus Martiny; Ida Hageman Journal: PLoS One Date: 2020-03-12 Impact factor: 3.240
Authors: Kirstin B VanderWall; Bin Lu; Jorge S Alfaro; Anna R Allsop; Alexa S Carr; Shaomei Wang; Jason S Meyer Journal: Sci Rep Date: 2020-10-15 Impact factor: 4.379