{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:22:23Z","timestamp":1790612543603,"version":"4.1.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Current standard methods in monitoring glaucoma progression, like optical coherence tomography (OCT) and standard automated perimetry (SAP), have limitations in certain cases. Automated relative afferent pupillary defect (RAPD) and pupillary light reflex (PLR) testing may offer more objective alternatives. This pilot study aimed to evaluate whether RAPD could sufficiently distinguish between the two eyes in asymmetrical glaucoma, and thus could lay the foundation for using the PLR of a single eye to monitor progression longitudinally.<\/jats:p><jats:p>\n          Methods Twenty-one patients underwent quantitative PLR measurements using a virtual reality headset. RAPD was calculated by subtracting the amplitude of PLRs between eyes. Both RAPD and relative SAP (measured using the mean defect or MD) results were correlated to the thickness of the peripapillary retinal nerve fiber layer (RNFL), as measured by OCT.<\/jats:p><jats:p>\n          Results Data from 18 patients was analyzed after exclusions. RAPD significantly correlated with differences between the two eyes as measured by RNFL thickness (Pearson r\u2009=\u20090.79, p\u2009=\u20090.05). MD differences correlated slightly better with RNFL differences (Pearson r\u2009=\u20090.87, p\u2009&lt;\u20090.05). RAPD and MD combined yielded an improved prediction of RNFL differences by 5% compared to using MD only.<\/jats:p><jats:p>\n          Conclusions RAPD measurements reliably detected asymmetries in optic nerve damage in glaucoma patients. SAP measurements correlated better with OCT results than RAPD results. However, SAP and RAPD combined led to an improved prediction of RNFL thickness. This could possibly allow us to use PLR only over longer periods of time to monitor glaucomatous optic nerve damage in a single eye in the future.<\/jats:p>","DOI":"10.1055\/a-2460-0147","type":"journal-article","created":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:24:32Z","timestamp":1733531072000},"page":"379-383","source":"Crossref","is-referenced-by-count":2,"title":["Use of a Novel Virtual Reality-Based Pupillography Device for Glaucoma Management: Cross-Sectional Cohort Pilot Study"],"prefix":"10.1055","volume":"242","author":[{"given":"Karim","family":"El-Koussy","sequence":"additional","affiliation":[{"name":"Medizinische Fakult\u00e4t, Universit\u00e4t Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"H\u00f6hn","sequence":"additional","affiliation":[{"name":"Ophthalmology, Eyeparc, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana B. L.","family":"Falc\u00e3o","sequence":"additional","affiliation":[{"name":"Analytics, machineMD, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Hauser","sequence":"additional","affiliation":[{"name":"Analytics, machineMD, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avantika","family":"Naidu","sequence":"additional","affiliation":[{"name":"Analytics, machineMD, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Abegg","sequence":"additional","affiliation":[{"name":"Analytics, machineMD, Bern, Switzerland"},{"name":"Department of Ophthalmology, University Hospital Zurich, Switzerland"},{"name":"ONOVIS Augenpraxis, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis","volume":"121","author":"Y C Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/bs.pbr.2015.05.005","article-title":"Retinal ganglion cell apoptotic pathway in glaucoma: Initiating and downstream mechanisms","volume":"220","author":"H Levkovitch-Verbin","year":"2015","journal-title":"Prog Brain Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0079-6123(08)01106-0","article-title":"Monitoring Glaucoma Progression","volume":"173","author":"P Brusini","year":"2008","journal-title":"Prog Brain 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Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1016\/j.ophtha.2013.04.012","article-title":"Accuracy of pupil assessment for the detection of glaucoma: a systematic review and meta-analysis","volume":"120","author":"D S Chang","year":"2013","journal-title":"Ophthalmology"},{"key":"ref11","first-page":"200","article-title":"The usefulness of a new method of testing for a relative afferent pupillary defect in patients with ocular hypertension and glaucoma","volume":"103","author":"D Lankaranian","year":"2005","journal-title":"Trans Am Ophthalmol Soc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2953","DOI":"10.1167\/iovs.13-13482","article-title":"Structure-function relationships with spectral-domain optical coherence tomography retinal nerve fiber layer and optic nerve head measurements","volume":"55","author":"F Pollet-Villard","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1055\/a-1098-3466","article-title":"OCT-Diagnostik beim Glaukom: Tipps & Tricks","volume":"237","author":"C Mardin","year":"2020","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.ogla.2020.12.001","article-title":"Predicting Global Test-Retest Variability of Visual Fields in Glaucoma","volume":"4","author":"E Y Choi","year":"2021","journal-title":"Ophthalmol Glaucoma"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr 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