Comparison of threshold visual perimetry and objective pupil perimetry in clinical patients

Objectives: In an attempt to measure the visual field objectively, we have performed pupil perimetry, by which the pupil light reflex is monitored in response to perimetric light stimuli. The purpose of this study was to asce rtain whether pupil perimetry reveals defects similar to those revealed by standard threshold perimetry in patients with various diseases. Material and Methods: An infrared pupillometer was linked to an automated p erimeter to record, at each perimetric location, 76 pupil contractions, whi ch were comparable to the test locations of the Humphrey Field Analyzer (HF A 30-2 program; Humphrey, San Leandro, CA). One hundred eighteen patients w ith various diseases were investigated. Results: Ninety-one patients (77.1%) maintained a pupil area large enough ( more than 10 mm(2) in area) to respond adequately to focal light stimuli th roughout the test. The correlation between the pupil field and the threshol d visual field was subjectively judged to be good in most cases. However, p upil perimetry showed less damage than that seen in threshold perimetry in six of nine patients who had Leber's hereditary optic neuropathy(LHON). Conclusions: Pupil perimetry is a good method for measuring the visual fiel d objectively and has potential for clinical use in most of the cases.