Assessment of pupillary light reflex using dynamic pupillometry in laser-treated eyes with retinal vein occlusion

Purpose: This study aims to evaluate the pupillary light reflex measured with dynamic pupillometry in patients who underwent retinal laser photocoagulation due to unilateral retinal vein occlusion (RVO). Methods: A total of 48 patients with unilateral RVO were included in the study. Thirty-four patients had undergone retinal laser photocoagulation while the remaining 14 patients that did not undergo laser treatment were observed for control purposes. Of the laser-treated eyes, 14 eyes (41.2%) had central RVO (CRVO) and 20 eyes (58.8%) had branch RVO (BRVO). Among the 14 patients with RVO without laser treatment, nine eyes (64.3%) had CRVO and five eyes (35.7%) had BRVO. Pupillary light reflexes were assessed with dynamic pupillometry (MonPackOne®; Metrovision, France). The parameters of the eyes with RVO were compared with that of fellow healthy eyes. Results: Mean patient age was 65.8 ± 10.4 years and median time after photocoagulation was 25.5 months. Eyes that received laser photocoagulation had lower pupil contraction amplitude ( p = 0.037), prolonged contraction latency ( p = 0.027), slower contraction velocity ( p = 0.043), and slower dilation velocity ( p < 0.001) compared to healthy fellow eyes. Subgroup analysis revealed that eyes with CRVO had lower contraction amplitude ( p = 0.013) and slower dilation velocity ( p = 0.003), and eyes with BRVO had slower dilation velocity ( p = 0.003). Non-laser-treated eyes with RVO revealed no significant difference in any of the pupillary light reflex parameters compared to fellow eyes. Conclusion: Laser-treated eyes with RVO demonstrated changes in pupillary light reflex parameters including reduced contraction amplitude, prolonged contraction latency, and slower contraction and dilation velocities measured with dynamic pupillometry.

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Correlation between Transient Pupillary Light Reflex and Retinal Function Impairment in Patients with Retinitis Pigmentosa

Journal of Ophthalmology ◽

10.1155/2018/2519375 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Yan He ◽

Huanyu Tang ◽

Gang Wang ◽

Bangqi Ren ◽

Yi Wang ◽

...

Keyword(s):

Retinitis Pigmentosa ◽

White Light ◽

Visual Function ◽

Pupillary Light Reflex ◽

Clinical Approach ◽

Retinal Sensitivity ◽

Light Reflex ◽

Pupillary Light ◽

Significant Difference ◽

Fixation Stability

Purpose. To investigate the relationship between transient pupillary light reflex (PLR) and visual function in patients with retinitis pigmentosa (RP). Methods. A retrospective study was performed with 137 eyes of 73 patients with RP. Transient pupillary light reflex was measured by the vision monitor system (MonColor; Metrovision, France). Dark-adapted transient PLRs were elicited by four specific levels of stimulus luminance (−5, −3, −1, and 0 log cd/m2, blue or white light). Best-corrected visual acuity (BCVA) was recorded based on Early Treatment Diabetic Retinopathy Study (ETDRS) acuity charts. Fixation stability and retinal sensitivity of radial 10° areas were measured with microperimetry. The retinal sensitivity (RS) was divided into central RS (fovea and radial 1° areas) and peripheral RS (radial 3° and 5° areas from the fovea). The patients were further classified into 2 groups (P1 > 75% and P1 < 75%) according to fixation stability. Spearman’s correlation was performed to identify significant associations between BCVA, fixation stability, RS, and PLR. Results. Under the stimuli of the same color light, relative pupillary constriction (RPC), latency, or velocity of constriction in the same patients was statistically different in multiple luminance, respectively. Under the same luminance, blue light induced greater RPC and velocity (except for −3 log cd/m2) than white light. Most patients showed varying degrees of threshold elevation and visual function deficiency. Besides, there was a statistically significant difference in the distribution of BCVA, MRS, or fixation stability under different thresholds. The correlation between pupillary constrictive area (PCA) and retinal sensitivity was mainly determined by the peripheral region. Moreover, patients with stable fixation showed a greater correlation between PCA and RS. Conclusion. PLR induced by specific colors and luminance may serve as a promising clinical approach for assessing and monitoring rod function in advanced RP patients.

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Assessment of the autonomic nervous system function in infants: the pupillary light reflex: normative data and physiological observations

Neuropediatrics ◽

10.1055/s-2006-953616 ◽

2006 ◽

Vol 37 (03) ◽

Author(s):

E Longin ◽

N Shazi ◽

C Dimitrios ◽

T Gerstner ◽

T Lenz ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Normative Data ◽

Pupillary Light Reflex ◽

System Function ◽

Autonomic Nervous System Function ◽

Light Reflex ◽

Autonomic Nervous ◽

Pupillary Light ◽

Nervous System Function

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Atypical Pupillary Light Reflex in Individuals With Autism

10.21236/ada614233 ◽

2012 ◽

Author(s):

Gang Yao

Keyword(s):

Pupillary Light Reflex ◽

Light Reflex ◽

Pupillary Light

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Variable abnormality of the melanopsin-derived portion of the pupillary light reflex (PLR) in patients with Parkinson’s disease (PD) and parkinsonism features

Neurological Sciences ◽

10.1007/s10072-021-05245-8 ◽

2021 ◽

Author(s):

Bruce I. Gaynes ◽

Adnaan Zaffer ◽

Raman Yousefzai ◽

Mario Chazaro-Cortes ◽

Kalea Colletta ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pupillary Light Reflex ◽

Light Reflex ◽

Pupillary Light

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Cost-effectiveness analysis of ranibizumab for retinal vein occlusion patients in China from the societal perspective

BMC Ophthalmology ◽

10.1186/s12886-021-01997-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weiyi Ni ◽

Jia Liu ◽

Yawen Jiang ◽

Jing Wu

Keyword(s):

Cost Effectiveness ◽

Retinal Vein Occlusion ◽

Societal Perspective ◽

Laser Photocoagulation ◽

Cost Effective ◽

Sensitivity Analyses ◽

Gdp Per Capita ◽

Base Case ◽

Vein Occlusion ◽

Per Capita

Abstract Background Clinical trials in China have demonstrated that ranibizumab can improve the clinical outcomes of branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). However, no economic evaluation of ranibizumab has been conducted among Chinese patient population. Methods To provide insights into the economic profile of ranibizumab among Chinese RVO population, a Markov state-transition model was used to predict the outcomes of ranibizumab comparing to laser photocoagulation and observational-only care from the societal perspective. This model simulated changes in patient visuality, quality-adjusted of life years (QALY), medical costs, and direct non-medical costs of individuals with visual impairment due to BRVO or CRVO in lifetime. The base-case analysis used an annual discount rate of 5% for costs and benefits following the China Guidelines for Pharmacoeconomic Evaluations. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the model. Results The base-case incremental cost-effectiveness ratio (ICER) comparing ranibizumab to laser photocoagulation was ¥65,008/QALY among BRVO patients and was ¥65,815/QALY among CRVO patients, respectively. Comparing to the 2019 gross domestic product (GDP) per capita of ¥71,000, both two ICERs were far below the cost-effective threshold at three times of GDP per capita (¥213,000). The deterministic and probabilistic sensitivity analyses demonstrated the base-case results were robust in most of the simulation scenarios. Conclusion The current Markov model demonstrated that ranibizumab may be cost-effective compared with laser photocoagulation to treat BRVO and cost-effective compared to observation-only care to treat CRVO in China from the societal perspective.

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Retinal venous pressure is decreased after anti-VEGF therapy in patients with retinal vein occlusion–related macular edema

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-05068-x ◽

2021 ◽

Author(s):

Teruyo Kida ◽

Josef Flammer ◽

Katarzyna Konieczka ◽

Tsunehiko Ikeda

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Venous Pressure ◽

Decisive Role ◽

Retinal Venous Pressure ◽

Vein Occlusion ◽

Anti Vegf ◽

Significant Difference ◽

Endothelial Growth Factor

Abstract Purpose The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable.

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