Dynamic Pupillary Functions Affected in Early Stage Glaucoma

Dynamic pupillary functions, such as light response, appear to undergo quantitative changes in patients with early-stage primary open angle glaucoma (POAG), according to research published in the Journal of Glaucoma. The latency of pupil dilation time is longer, the duration of pupil dilation is shorter, and velocity of pupil dilation is lower in these patients than those without glaucoma, the researchers report.

Researchers conducted a prospective study comparing static and dynamic pupillary functions in patients with treatment-naive, newly diagnosed, early-stage primary open angle glaucoma (40 eyes of 40 patients; mean age, 60.9±9.6 years; 65% men, 35% women) with those of a healthy control group (71 eyes of 71 patients; mean age, 57.6±8.2 years; 63% men, 37% women). They captured static and dynamic pupillary functions using an automated pupillometry device.

The POAG group had a shorter duration of pupil contraction (mean, 638.2±96.7 vs 602.6±84.9 milliseconds [ms]; P =.04), longer latency of pupil dilation time (907.7±79.7 vs 859.5±129.6 ms; P =.03), shorter duration of pupil dilation (1545.7±130.9 vs 1594.8±112.4; P =.04), and lower velocity of pupil dilation (1.7±0.6 vs 2.0±0.1; P =.02) than the participants in the control group. No significant differences were observed between the groups for resting pupil diameter or any static pupillometry characteristics.

Monitoring these dynamic pupillary functions using automated pupillometry could provide a quantitative, reproducible, inexpensive biomarker that would aid clinicians in the early diagnosis of primary open angle glaucoma. 

“If these results are confirmed by longitudinal studies on larger series and if glaucoma progression and pupillometry parameters can be directly correlated, automated pupillometry may be a useful clinical diagnostic method for detecting early-stage glaucoma,” suggest the researchers.

Limitations of the study included the cross-sectional design, relatively small study groups consisting of only participants who were White, and the exclusion of patients based on self-reported disease history.