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Pupillographic Measurements with Pattern Stimulation: The Pupil’s Response in Normal Subjects and First Measurements in Glaucoma Patients

¹From the Departments of Ophthalmology and ³Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany; and the ²Siemens Medical Engineering Group, Erlangen, Germany.

PURPOSE. This study was undertaken to characterize the influence of contrast, luminance, and spatial frequency of a pattern stimulus on the pupil reaction of healthy subjects. First measurements with this technique in patients with glaucoma were compared with those in a control group.

METHOD. Grating patterns were presented using a Maxwellian-view system to study series of contrast, luminance, and spatial frequency in three healthy subjects. The best two stimulus conditions were determined and were then used to examine 19 patients with open-angle glaucoma and 16 control subjects.

RESULTS. In healthy subjects, an increasing contrast led to an increase in amplitude and a decrease in latency of the pupil reflex. Increasing luminance also resulted in an increase in the amplitude. The offset component of the pupil reflex was most pronounced at low spatial frequencies and the onset component at high spatial frequencies. When healthy subjects were compared with patients with glaucoma, control subjects generally had higher amplitudes, velocity, and acceleration of pupil constriction than did the patients with glaucoma. These differences were significant when the test was performed with a spatial frequency of 6.25 cyc/deg.

CONCLUSIONS. Best stimulus conditions to elicit a pupil response to a pattern grating stimulus are 100% contrast and 55 cd/m² mean luminance. The choice of the spatial frequency determines which component of the pupil reflex is more pronounced. Differences between patients with glaucoma and healthy control subjects are demonstrable.