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评估青光眼存在和进展的快速方法——一种可用于诊断、评估进展和治疗反应的方法。该测试将是客观的，不需要患者执行任务，并将在一次测试中评估视网膜实质性区域的状态。目前的目标是开发一种利用瞳孔光反射检测青光眼损伤的新方法。实现这一目标的具体步骤是：(1)将开发一种快速的方法来评估大尺寸视网膜区域的相对灵敏度。(2)确定正常受试者测试结果的变异程度。将确定受试者内变异，以评估测试方法的稳定性。将确定受试者之间的变化，以评估正态的变化范围。(3)测试的灵敏度将被评估，使用自然的，可量化的不对称在正常视网膜地形。这将提供关于缺陷程度和测试结果之间关系的信息。与“2”的变异性结果一起，这应该提供与视网膜缺陷程度及其可检测性相关的功能估计。(4)测试的效果将由一组视力严重丧失的患者来评估。对于青光眼患者，刺激将被设计成利用当前知识的典型模式的视网膜受青光眼损害的影响。这将允许常规视野的结果与瞳孔测试的结果进行比较。(5)使用一组中度青光眼患者来评估该测试的性能。这将允许对视野缺陷不太明显的患者进行测试评估，将测试用于评估青光眼疑似患者。将研究试验结果与青光眼丧失的严重程度之间的关系，以确定该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.