A Rapid Pupillometric Test for Glaucoma

描述（由申请人提供）：拟议研究的长期目标是开发一种快速评估青光眼存在和进展的方法-一种可用于诊断和评估进展以及治疗反应的方法。该测试将是客观的，不需要患者执行任务，并且将在单个测试中评估视网膜的实质区域的状态。目前的目标是开发一种新的方法来测试昏迷损害，使用瞳孔对光反射。 实现这一目标的具体步骤是：（1）将开发一种快速方法来评估相当大尺寸的视网膜区域的相对灵敏度。(2)将确定正常受试者中检测结果的变异程度。 将确定受试者内变异，以评估检测方法的稳定性。 将确定受试者间变异，以评估正常值的变异范围。(3)将使用正常视网膜地形图中自然的、可量化的不对称性来评估测试的灵敏度。 这将提供有关缺陷程度与测试结果之间关系的信息。 连同来自“2”的可变性结果，这应该提供与视网膜缺陷的程度与其可检测性相关的函数的估计。(4)将使用一组视野严重丧失的患者评估测试性能。 对于青光眼患者，刺激将被设计为利用受青光眼损伤影响的视网膜的典型模式的现有知识。 这将允许比较常规视野的结果与瞳孔测试的结果。(5)将使用一组中度昏迷丧失的患者评估测试的性能。 这将允许对视野缺损不太明显的患者进行测试评估，将测试用于评估青光眼嫌疑人。 将研究试验结果与脑卒中损失严重程度之间的关系，以确定试验在临床环境中提供有用信息的能力。

DESCRIPTION (provided by applicant): The long-term goal of the proposed research is to develop a rapid method of assessing the presence and progress of glaucoma -- a method which could be useful both for diagnosis and for evaluating progression and for response to treatment. The test will be objective, not requiring a patient to perform tasks, and will evaluate the status of substantial areas of retina in a single test. The immediate goal is to develop a new method of testing for glaucomatous damage, using the pupillary light reflex. The specific steps in reaching this goal are: (1) A rapid method will be developed for assessing the comparative sensitivity of retinal regions of substantial size. (2) The extent of variation of the test results in normal subjects will be determined. Within-subject variation will be determined to assess the stability of the testing method. Between-subject variation will be determined to assess the range of variation in normals. (3) The sensitivity of the test will be assessed, using natural, quantifiable asymmetries in normal retinal topography. This will provide information on the relationship between the extent of a defect and the results on the test. Together with the variability results from "2", this should provide an estimate of the function relating the extent of a retinal defect to its detectability. (4) The performance of the test will be assessed, using a group of patients who have substantial visual field loss. For glaucoma patients, the stimuli will be designed to exploit current knowledge of typical patterns of retina affected by glaucomatous damage. This will permit comparison of results from conventional visual fields with results of the pupillometric test. (5) The performance of the test will be assessed, using a group of patients with moderate glaucomatous loss. This will permit evaluation of the test on patients with less obvious field defects, moving the testing towards use in evaluating glaucoma suspects. The relationship between the results of the test and the severity of the glaucomatous loss will be studied to determine the power of the test to provide useful information in a clinical setting.