Abstract
Purpose To develop and validate an associative model using pupillography that best discriminates those with and without glaucoma. Design A prospective case-control study. Methods We enrolled 148 patients with glaucoma (mean age 67 ± 11) and 71 controls (mean age 60 ± 10) in a clinical setting. This prototype pupillometer is designed to record and analyze pupillary responses at multiple, controlled stimulus intensities while using varied stimulus patterns and colors. We evaluated three approaches: (1) comparing the responses between the two eyes; (2) comparing responses to stimuli between the superonasal and inferonasal fields within each eye; and (3) calculating the absolute pupil response of each individual eye. Associative models were developed using stepwise regression or forward selection with Akaike information criterion and validated by fivefold cross-validation. We assessed the associative model using sensitivity, specificity and the area-under-the-receiver operating characteristic curve. Results Persons with glaucoma had more asymmetric pupil responses in the two eyes (P <0.001); between superonasal and inferonasal visual field within the same eye (P = 0.014); and smaller amplitudes, slower velocities and longer latencies of pupil responses compared to controls (all P <0.001). A model including age and these three components resulted in an area-under-the-receiver operating characteristic curve of 0.87 (95% CI 0.83 to 0.92) with 80% sensitivity and specificity in detecting glaucoma. This result remained robust after cross-validation. Conclusions Using pupillography, we were able to discriminate among persons with glaucoma and those with normal eye examinations. With refinement, pupil testing may provide a simple approach for glaucoma screening.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Ophthalmology |
| Volume | 156 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 2013 |
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ASJC Scopus subject areas
- Ophthalmology
Cite this
Development and validation of an associative model for the detection of glaucoma using pupillography. / Chang, Dolly S.; Arora, Karun S.; Boland, Michael; Supakontanasan, Wasu; Friedman, David S.
In: American Journal of Ophthalmology, Vol. 156, No. 6, 12.2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Development and validation of an associative model for the detection of glaucoma using pupillography
AU - Chang, Dolly S.
AU - Arora, Karun S.
AU - Boland, Michael
AU - Supakontanasan, Wasu
AU - Friedman, David S
PY - 2013/12
Y1 - 2013/12
N2 - Purpose To develop and validate an associative model using pupillography that best discriminates those with and without glaucoma. Design A prospective case-control study. Methods We enrolled 148 patients with glaucoma (mean age 67 ± 11) and 71 controls (mean age 60 ± 10) in a clinical setting. This prototype pupillometer is designed to record and analyze pupillary responses at multiple, controlled stimulus intensities while using varied stimulus patterns and colors. We evaluated three approaches: (1) comparing the responses between the two eyes; (2) comparing responses to stimuli between the superonasal and inferonasal fields within each eye; and (3) calculating the absolute pupil response of each individual eye. Associative models were developed using stepwise regression or forward selection with Akaike information criterion and validated by fivefold cross-validation. We assessed the associative model using sensitivity, specificity and the area-under-the-receiver operating characteristic curve. Results Persons with glaucoma had more asymmetric pupil responses in the two eyes (P <0.001); between superonasal and inferonasal visual field within the same eye (P = 0.014); and smaller amplitudes, slower velocities and longer latencies of pupil responses compared to controls (all P <0.001). A model including age and these three components resulted in an area-under-the-receiver operating characteristic curve of 0.87 (95% CI 0.83 to 0.92) with 80% sensitivity and specificity in detecting glaucoma. This result remained robust after cross-validation. Conclusions Using pupillography, we were able to discriminate among persons with glaucoma and those with normal eye examinations. With refinement, pupil testing may provide a simple approach for glaucoma screening.
AB - Purpose To develop and validate an associative model using pupillography that best discriminates those with and without glaucoma. Design A prospective case-control study. Methods We enrolled 148 patients with glaucoma (mean age 67 ± 11) and 71 controls (mean age 60 ± 10) in a clinical setting. This prototype pupillometer is designed to record and analyze pupillary responses at multiple, controlled stimulus intensities while using varied stimulus patterns and colors. We evaluated three approaches: (1) comparing the responses between the two eyes; (2) comparing responses to stimuli between the superonasal and inferonasal fields within each eye; and (3) calculating the absolute pupil response of each individual eye. Associative models were developed using stepwise regression or forward selection with Akaike information criterion and validated by fivefold cross-validation. We assessed the associative model using sensitivity, specificity and the area-under-the-receiver operating characteristic curve. Results Persons with glaucoma had more asymmetric pupil responses in the two eyes (P <0.001); between superonasal and inferonasal visual field within the same eye (P = 0.014); and smaller amplitudes, slower velocities and longer latencies of pupil responses compared to controls (all P <0.001). A model including age and these three components resulted in an area-under-the-receiver operating characteristic curve of 0.87 (95% CI 0.83 to 0.92) with 80% sensitivity and specificity in detecting glaucoma. This result remained robust after cross-validation. Conclusions Using pupillography, we were able to discriminate among persons with glaucoma and those with normal eye examinations. With refinement, pupil testing may provide a simple approach for glaucoma screening.
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UR - http://www.scopus.com/inward/citedby.url?scp=84887883389&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2013.07.026
DO - 10.1016/j.ajo.2013.07.026
M3 - Article
C2 - 24011523
AN - SCOPUS:84887883389
VL - 156
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 6
ER -