A Positive Association Between Intrinsically Photosensitive Retinal Ganglion Cells and Retinal Nerve Fiber Layer Thinning in Glaucoma

Author(s)

Gracitelli, Carolina P. B. ^[1] ; Duque-Chica, Gloria L. ^[2] ; Moura, Ana Laura ^{[2, 1]} ; Nagy, Balazs V. ^[2] ; de Melo, Geraldine R. ^[1] ; Roizenblatt, Marina ^[1] ; Borba, Paula D. ^[1] ; Teixeira, Sergio H. ^[1] ; Ventura, Dora F. ^[2] ; Paranhos, Jr., Augusto ^[1]

Affiliation

^[1] Univ Fed Sao Paulo, Dept Ophthalmol, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Inst Psychol, Sao Paulo - Brazil

• Document type: Journal article
• Source: INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE; v. 55, n. 12, p. 7997-8005, DEC 2014.
• Web of Science Citations: 26

Abstract

PURPOSE. To assess the integrity of intrinsically photosensitive retinal ganglion cells (ipRGCs) using the pupillary light reflex in glaucoma patients. METHODS. A cross-sectional study was conducted, including 76 eyes from 38 patients with primary open-angle glaucoma and 36 eyes from 18 control subjects. The patients were tested in the dark with light stimuli using the Ganzfeld system, and the pupil diameter was measured with the assistance of an eye tracker consisting of two infrared cameras fit to an eyeglass frame. To preferentially stimulate ipRGCs, we used a 1-second 470-nm flash with a luminance of 250 cd/m(2). To stimulate different retinal photoreceptors (cones and rods), we used a 1-second 630-nm flash with a luminance of 250 cd/m(2). Standard automated perimetry (SAP), matrix frequency-doubling technology (FDT), and high-definition optical coherence tomography (Cirrus HD-OCT) were also performed. The correlation between the ipRGC-mediated sustained response following the pupillary light reflex and the structural and functional changes in glaucoma patients was analyzed using generalized estimating equation. RESULTS. An association was observed between the average retinal nerve fiber layer (RNFL) thickness, as measured by Cirrus HD-OCT, and the sustained pupillary response to the blue flash (P = 0.024). The severity of glaucoma, based on the mean deviation of SAP (Hodapp-Anderson-Parrish system), was also associated with the sustained response to the blue flash (P = 0.006). CONCLUSIONS. This study showed a correlation between the mean RNFL thickness and the pupillary light response. A decrease in the number of ipRGCs is potentially related to the reduced RNFL thickness. (AU)

• FAPESP's process: 08/58731-2 - Vision as a sensitive indicator of conditions threatening retinal and central nervous system function
• Grantee: Dora Selma Fix Ventura
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 13/03553-0 - Study of the role of melanopsin through the pupillary light response in optic neuropathy and disturbed sleep
• Grantee: Gloria Liliana Duque Chica
• Support Opportunities: Scholarships in Brazil - Doctorate