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How lesions at different locations along the visual pathway influence pupillary reactions to chromatic stimuli.

Authors :
Kelbsch C
Stingl K
Jung R
Kempf M
Richter P
Strasser T
Peters T
Wilhelm B
Wilhelm H
Tonagel F
Source :
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2022 May; Vol. 260 (5), pp. 1675-1685. Date of Electronic Publication: 2021 Dec 13.
Publication Year :
2022

Abstract

Purpose: To examine systematically how prechiasmal, chiasmal, and postchiasmal lesions along the visual pathway affect the respective pupillary responses to specific local monochromatic stimuli.<br />Methods: Chromatic pupil campimetry (CPC) was performed in three patient groups (10 subjects with status after anterior ischemic optic neuropathy, 6 with chiasmal lesions, and 12 with optic tract or occipital lobe lesions (tumor, ischemia)) using red, low-intensity red, and blue local stimuli within the central 30° visual field. Affected areas - as determined by visual field defects revealed using conventional static perimetry - were compared with non-affected areas. Outcome parameters were the relative maximal constriction amplitude (relMCA) and the latency to constriction onset of the pupillary responses.<br />Results: A statistically significant relMCA reduction was observed in the affected areas of postchiasmal lesions with red (p = 0.004) and low-intensity red stimulation (p = 0.001). RelMCA reduction in the affected areas seemed more pronounced for low-intensity red stimulation (46.5% mean reduction compared to non-affected areas; 36% for red stimulation), however statistically not significant. In prechiasmal lesions, a statistically significant latency prolongation could be demonstrated in the affected areas with low-intensity red stimulation (p = 0.015).<br />Conclusion: Our results indicate that the choice of stimulus characteristics is relevant in detecting defects in the pupillary pathway of impairment along the visual pathway, favoring red stimuli of low intensity over blue stimuli. Such knowledge opens the door for further fundamental research in pupillary pathways and is important for future clinical application of pupillography in neuro-ophthalmologic patients.<br /> (© 2021. The Author(s).)

Details

Language :
English
ISSN :
1435-702X
Volume :
260
Issue :
5
Database :
MEDLINE
Journal :
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
Publication Type :
Academic Journal
Accession number :
34902059
Full Text :
https://doi.org/10.1007/s00417-021-05513-5