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Automated Pupillometry using a Prototype Binocular Optical Coherence Tomography System

Chopra, R; Mulholland, PJ; Petzold, A; Ogunbowale, L; Gazzard, G; Bremner, F; Anderson, RS; (2020) Automated Pupillometry using a Prototype Binocular Optical Coherence Tomography System. American Journal of Ophthalmology , 214 pp. 21-31. 10.1016/j.ajo.2020.02.013. Green open access

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Abstract

PURPOSE: To determine the test-retest reliability and diagnostic accuracy of a binocular optical coherence tomography (OCT) prototype (Envision Diagnostics, USA) for pupillometry. DESIGN: Assessment of diagnostic reliability and accuracy. METHODS: Fifty participants with RAPD confirmed using the swinging flashlight method (mean age 49.6 years) and 50 healthy controls (mean age 31.3 years) were examined. Participants twice underwent an automated pupillometry exam using a binocular OCT system that presents a stimulus and simultaneously captures OCT images of the iris-pupil plane of both eyes. Participants underwent a single exam on the RAPDx (Konan Inc, USA), an automated infrared pupillometer. Pupil parameters including maximum and minimum diameter, and anisocoria were measured. The magnitude of RAPD was calculated using the log of the ratio of the constriction amplitude between the eyes. A pathological RAPD was considered to be above ±0.5 log units on both devices. RESULTS: Intraclass correlation coefficient was >0.90 for OCT-derived maximum pupil diameter, minimum pupil diameter, anisocoria. The RAPDx had a sensitivity of 82% and a specificity of 94% for detection of RAPD whereas the binocular OCT had a sensitivity of 74% and specificity of 86%. The diagnostic accuracy of the RAPDx and binocular OCT was 88% (CI: 80-94%) and 80% (CI: 71-87%) respectively. CONCLUSIONS: Binocular OCT-derived pupil parameters had excellent test-retest reliability. Diagnostic accuracy of RAPD was inferior to the RAPDx and is likely related to factors such as eye movement during OCT capture. As OCT becomes ubiquitous, OCT-derived measurements may provide an efficient method of objectively quantifying the pupil responses.

Type: Article
Title: Automated Pupillometry using a Prototype Binocular Optical Coherence Tomography System
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ajo.2020.02.013
Publisher version: https://doi.org/10.1016/j.ajo.2020.02.013
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Automated, Binocular, Diagnostics, Optical coherence tomography, Pupillometry, Pupils
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10093141
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