Comparing the effects on the visual fields following pre and post pupillary dilatation

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Comparing the effects on the visual fields following pre and post pupillary dilatation

Journal Title: Medpulse International Journal of Ophthalmology - Year 2017, Vol 3, Issue 1

Abstract

Aim: To compare the visual fields plotted by automated perimetry without and with pupillary dilation. Methods: This was a prospective, comparative, non interventional, single center observational study at the hospital settings. This study was conducted at Sarojini Devi Eye Hospital, Hyderabad between November 2006 and October 2007. Normal subjects were included in this study. The main endpoints was to measure visual fields with and without pupillary dilatation. Data analysis was done with the single field analysis printouts were collected and the data tabulated and analyzed using the paired Student’s t test. p ≤ 0.05 was considered statistically significant. Results: Overall, 35 eyes from the 19 subjects were included in this study, 10 were male (52.6%) and 9 were female (47.4%). The age ranged from 17 to 35 years, with mean of 22.9 years (males: 24.9 years and females: 20.7 years). Following the dilation with the phenylephrine eye drops 74.28% (n = 26) of the subjects had pupillary dilation of 7 to 8 mm in diameter, 20% (n = 7) had 6 mm dilation and 5.72% (n = 2) had 9 mm dilation with mean dilation of 7.28 ± 0.86 mm in diameter. The worsening of mean deviation (MD) was more in eyes with variation of pupil size by 5 mm (MD = -0.36 dB) compared to lower dilatations of 3 (MD = -0.1509 dB) and 4 (MD = -0.3053 dB) pupil sizes. The mean difference in MD was statistically significant worsening with 0.27 (with SD: 0.45; p = 0.001). The mean ± SD, pattern standard deviation (PSD) value at baseline was -2.14 ± 0.93 dB and after dilation was 1.64 ± 0.40 dB. The mean difference in PSD was improved without statistically significance difference of 0.10 ± 0.45 (p = 0.199). The increase in dilation of the pupil the MD worsened in 90.9% eyes of Δ5 mm of pupil size (p = 0.0038). However, the improvement in the PSD was noted in 72.2 % eyes with a 5 mm dilation of pupil from the baseline pupil size. There was a decrease in the foveal threshold (FT) by a mean of 0.14±1.91 dB after dilation which was again not statistically significant. Conclusions: There was statistically significant worsening of the MD (p < 0.01) after pupillary dilation. There was no statistically significant change in the PSD and FT threshold after pupillary dilation. Hence this study emphasizes the importance of consistent pupil diameter in serial visual field testing. Further comparative studies may be required on normal and glaucomatous subjects.

Authors and Affiliations

Rajitha Kondam, Phaniraj Kathuri

Keywords

visual fields automated perimetry pupillary dilation mean deviation pattern standard deviation foveal threshold.

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EP ID EP259914
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