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的存在和进展的方法--一种对诊断、评估进展和治疗反应都有用的方法。这项测试将是客观的，不要求患者执行任务，并将在一次测试中评估视网膜实质区域的状态。眼下的目标是开发一种利用瞳孔光反射来测试青光眼损害的新方法。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视网膜大小区域的相对敏感度。(2)将确定正常受试者测试结果的变异程度。将确定受试者内的变异以评估测试方法的稳定性。受试者之间的变异将被确定，以评估正常的变异范围。(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敏感性。这将提供有关缺陷程度和测试结果之间关系的信息。与“2”的可变性结果一起，这应该提供了将视网膜缺陷的程度与其可检测性联系起来的功能的估计。(4)将使用一组有严重视野丧失的患者来评估测试的性能。对于青光眼患者，这些刺激将被设计成利用目前对青光眼损害影响的典型视网膜模式的知识。这将允许将传统视野的结果与瞳孔测量测试的结果进行比较。(5)将使用一组中度青光眼患者对测试的性能进行评估。这将允许对视野缺陷不太明显的患者进行测试评估，使测试转向评估青光眼可疑患者。将研究测试结果与青光眼损失严重程度之间的关系，以确定该测试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.