In addition, PLR also acts as a protective mechanism to safeguard the retinal cells from phototoxic damage caused by any exposure to intense visible light. When transitioning from various light intensity levels, Pupil Diameter (PD) undergo dynamic alterations elicited by Pupillary Light Reflex (PLR), thereby assisting in the process of visual adaptation. The photosensitive cells in the human retina are uniformly adapted to function over a wide range of ambient light conditions. This proposed system, analysis strategies, and the tested metrics showed good short-term repeatability and the potential in detecting pupil abnormalities in neuro-ophthalmic diseases. The normal limits of the PRS coefficient ranged from − 0.20 to + 1.07 and all RAPD patients were outside the calculated normal limits. The mean (SD) Initial PD during dilation (3.2 (0.5) mm) and the minimum PD during constriction (2.9 (0.4) mm) in the light iris group had a statistically significant ( p < 0.001) higher magnitude compared to the dark iris group. A Pupil Response Symmetry (PRS) coefficient was calculated to predict the presence of RAPD. All the participants underwent a customized pupillometry protocol and the generated pupil traces, captured by an eye tracker, were analyzed using exponential fits to derive PLR parameters.
Our supplementary aim focused on evaluating the influence of iris colour on the PLR to decide whether a difference in PLR parameters should be anticipated when this system is used across ethnicities. This study described the development of a haploscope-based pupillometer for the parametrization of the Pupillary Light Reflex (PLR), and its feasibility in a set of 30 healthy subjects (light or dark-colored irides) and five patients diagnosed with Relative Afferent Pupillary Defect (RAPD).
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