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Melanopsin‐mediated pupillary light reflex and sleep quality in patients with normal tension glaucoma
Author(s) -
Ahmadi Hamid,
LundAndersen Henrik,
Kolko Miriam,
BachHolm Daniella,
Alberti Mark,
BaAli Shakoor
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14133
Subject(s) - pupillary light reflex , intrinsically photosensitive retinal ganglion cells , pupillometry , normal tension glaucoma , ophthalmology , glaucoma , pittsburgh sleep quality index , pupil , medicine , pupillary response , pupillary reflex , melanopsin , reflex , retinal , sleep quality , open angle glaucoma , psychology , retinal ganglion cell , neuroscience , photopigment , cognition , psychiatry
Purpose The intrinsically photosensitive retinal ganglion cells (ip RGC s) and sleep quality are impaired in patients with primary open‐angle glaucoma ( POAG ). In this study, we investigated whether ip RGC s and sleep quality were also impaired in patients with normal tension glaucoma ( NTG ). Methods We performed pupillometry and sleep quality assessment in 15 patients with NTG and 17 healthy age‐matched controls. Pupillometry protocol consisted of monocular stimulation with high illuminance (100 lux) red (633 nm, 300 cd/m 2 or 15.23 log quanta/cm 2 /s) and blue light (463 nm, 332 cd/m 2 or 15.27 log quanta/cm 2 /s) and binocular pupil measurements. Prior to light stimulation, patients were dark‐adapted for 5 min. The late postillumination pupillary response ( PIPR L ate ) to blue light was used as marker of ip RGC activity. Sleep quality was assessed by Pittsburgh Sleep Quality Index ( PSQI ) questionnaire. Results The PIPR L ate to blue light was significantly reduced in patients with NTG compared to healthy subjects (p < 0.001), indicating impairment of the melanopsin‐mediated pupillary pathway. There was no significant difference in the response elicited by red light (p = 0.6). Baseline pupil diameter and pupillary constriction amplitude to both red and blue light were reduced in patients with NTG (p < 0.05). The global score in PSQI was not significantly different between healthy controls and patients with NTG , indicating normal sleep quality (p = 0.6). Furthermore, we found no correlation between sleep parameters and pupillary light reflex parameters. Conclusion Patients with NTG exhibited reduced ip RGC activity compared to healthy subjects, while no differences were observed in sleep quality.