Assessment of Pupillary Response and Visual Field Defects by Objective Multifocal Chromatic Pupillometer in Patients With Pseudotumor Cerebri and Healthy Subjects
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Sheba Medical Center
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Measurement of maximal velocity of pupil contraction and dilation in response to chromatic light stimulus
Study Overview
Brief Summary
PTC(Pseudotumor cerebri) patients may develop increased Intracranial pressure (ICP) that can produces increased pressure around the distal optic nerve,which is likely followed by venule compression, ischemia, and loss of visual function.Vision loss in PTC is most commonly characterized by standard automated perimetry to measure peripheral visual field sensitivity.
Pupillometry is a promising approach for functional assessment in PTC because it is noninvasive, objective, performed quickly with minimal patient cooperation needed.
The feasibility of using chromatic multifocal pupillometry for assesment of PTC will be examined.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Diagnostic
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Healthy subjects
- •Male or female patients, age between 18 and 80 years, inclusive
- •Informed written consent will be obtained from all participants.
- •Normal eye examination
- •Best-corrected visual acuity (BCVA) of 20/20
- •Normal color vision test (Ishihara/HRR)
- •Normal Spectral-Domain Optical Coherence Tomography (SD-OCT)
- •Normal 24-2 Humphrey visual field (SITA Standard) and:
- •Short duration (≤10 minutes)
- •Minimal fixation losses, False POS errors and False NEG errors (less than 33% for each one of reliability indices)
- •PTC patients
- •Male or female patients, age between 18 and 80 years, inclusive
- •Best-corrected visual acuity (BCVA) of at least 20/100 in worse eye
- •Optic disc edema
- •PTC diagnosis based on Modified Dandy Criteria ( lumbar puncture with opening pressure higher than or equal to 25 cm H2O, normal cerebrospinal fluid constituents, and unremarkable brain imaging results except typical for PTC
Exclusion Criteria
- •Healthy subjects
- •History of past (last 3 months) or present ocular disease or ocular surgery
- •Use of any topical or systemic medications that could adversely influence pupillary reflex
- •Intolerance to gonioscopy, slit lamp examination, Goldmann applanation tonometry or other schedule study procedure.
- •Mental impairment or instability such as that informed consent may not be obtained or compliance with tester instructions is unlikely.
- •Visual media opacity including cloudy corneas.
- •Any condition preventing accurate measurement or examination of the pupil.
- •PTC patients
- •Any other neurologic or ophthalmic disease other than PTC
- •Use of any topical or systemic medications that could adversely influence pupillary reflex
- •Intolerance to gonioscopy, slit lamp examination, Goldmann applanation tonometry or other schedule study procedure.
- •Mental impairment or instability such as that informed consent may not be obtained or compliance with tester instructions is unlikely.
- •Visual media opacity including cloudy corneas.
- •Any condition preventing accurate measurement or examination of the pupil.
Arms & Interventions
Pseudotumor cerebri (PTC) patients
Intervention: objective chromatic multifocal pupillometer (Diagnostic Test)
Control
Intervention: objective chromatic multifocal pupillometer (Diagnostic Test)
Outcomes
Primary Outcomes
Measurement of maximal velocity of pupil contraction and dilation in response to chromatic light stimulus
Time Frame: single visit: 1 day
Pupil contraction and dilation velocity (in pixel/second) in response to blue and red light displayed at 76 test targets in a visual field of 30 degree will be measured in PTC patients and compared to matched controls
Measurement of maximal precentage of pupil contraction and dilation in response to chromatic light stimulus
Time Frame: single visit: 1 day
Percentage of pupil contraction and dilation in response to blue and red light displayed at 76 test targets in a visual field of 30 degree will be measured in PTC patients and compared to matched controls
Measurement of latency of pupil contraction and dilation in response to chromatic light stimulus
Time Frame: single visit: 1 day
Pupil contraction and dilation latency (in seconds) in response to blue and red light displayed at 76 test targets in a visual field of 30 degree will be measured in PTC patients and compared to matched controls
Secondary Outcomes
- Change from baseline pupil contraction and dilation precentage in PCT patients at 48 hours(single visit: 1 day, 48 hours after baseline testing)
- Change from baseline pupil contraction and dilation latency in PCT patients at 2 months.(single visit: 1 day, 2 months after baseline testing)
- Change from baseline pupil contraction and dilation latency in PCT patients at 48 hours(single visit: 1 day, 48 hours after baseline testing)
- Change from baseline pupil contraction and dilation maximal velocity in PCT patients at 2 months.(single visit: 1 day, 2 months after baseline testing)
- Change from baseline pupil contraction and dilation precentage in PCT patients at 1 week.(single visit: 1 day, 1 week after baseline testing)
- Change from baseline pupil contraction and dilation precentage in PCT patients at 2 months.(single visit: 1 day, 2 months after baseline testing)
- Change from baseline pupil contraction and dilation maximal velocity in PCT patients at 48 hours(single visit: 1 day, 48 hours after baseline testing)
- Change from baseline pupil contraction and dilation latency in PCT patients at 1 week.(single visit: 1 day, 1 week after baseline testing)
- Subjective visual field(single visit: 1 day)
- Optic nerve structure by OCT(single visit: 1 day)
- Change from baseline pupil contraction and dilation maximal velocity in PCT patients at 1 week.(single visit: 1 day, 1 week after baseline testing)
Investigators
Dr. Ygal Rotenstreich
Head of ElectrophisiologyClinic and Retinal Research Laboratory
Sheba Medical Center