Clinical evaluation of a rapid, pupil-based assessment of retinal damage associated with glaucoma

Aims: To evaluate the effectiveness of a new test, the Pupilmetrix™ PLR60, which uses the pupillary light reflex (PLR) to detect asymmetric retinal damage in patients diagnosed with glaucoma. Methods: 30 patients, clinically diagnosed as having glaucoma, were recruited to the study, 29 of whom completed testing using the PLR60. A control group of 30 patients who had glaucoma excluded by clinical examination were also recruited and tested using the same protocol on the PLR60. Results: Of the 110 eyes with test outcomes, overall agreement between the PLR60 result and clinical diagnosis (glaucoma positive or negative) per eye was 84.7%. Sensitivity was 93.1% (95% CI 77.2%–99.2%) and specificity was 76.7% (95% CI 57.7%–90.1%). Average (SD) test times (min:sec) for both eyes were 3:21 (0:33) minutes for the glaucoma group and 2:40 (0:35) minutes for the non-glaucoma group. Conclusions: The results of this preliminary study suggest that the PLR as used in the Pupilmetrix™ PLR60 test is able to discriminate between patients with glaucomatous retinal defects and those with clinically normal retinas with a diagnostic accuracy that is potentially useful for screening for glaucoma. Test times were markedly quicker than with standard visual field testing.