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Pupillary response to chromatic light stimuli as a possible biomarker at the early stage of glaucoma: a review

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Abstract

Glaucoma is a multifactorial neurodegenerative disease of the optic nerve currently considered a severe health problem because of its high prevalence, being the primary cause of irreversible blindness worldwide. The most common type corresponds to Primary Open-Angle Glaucoma. Glaucoma produces, among other alterations, a progressive loss of retinal ganglion cells (RGC) and its axons which are the key contributors to generate action potentials that reach the visual cortex to create the visual image. Glaucoma is characterized by Visual Field loss whose main feature is to be painless and therefore makes early detection difficult, causing a late diagnosis and a delayed treatment indication that slows down its progression. Intrinsically photosensitive retinal ganglion cells, which represent a subgroup of RGCs are characterized by their response to short-wave light stimulation close to 480 nm, their non-visual function, and their role in the generation of the pupillary reflex. Currently, the sensitivity of clinical examinations correlates to RGC damage; however, the need for an early damage biomarker is still relevant. It is an urgent task to create new diagnostic approaches to detect an early stage of glaucoma in a prompt, quick, and economical manner. We summarize the pathology of glaucoma and its current clinical detection methods, and we suggest evaluating the pupillary response to chromatic light as a potential biomarker of disease, due to its diagnostic benefit and its cost-effectiveness in clinical practice in order to reduce irreversible damage caused by glaucoma.

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Acknowledgements

Not applicable.

Funding

This research was supported by Fondo Concursable Interno Investigación 2022-DETEM Universidad de Chile and CONICYT-PFCHA/Doctorado Nacional/2020–21200346.

Author information

Authors and Affiliations

  1. Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Santiago, Chile

    Carla Arévalo-López & Iván Plaza-Rosales

  2. Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Santiago, Chile

    Silvia Gleitze, Samuel Madariaga & Iván Plaza-Rosales

  3. Laboratorio de Neurosistemas, Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile

    Samuel Madariaga & Iván Plaza-Rosales

  4. Ecological Cognitive Neuroscience Group, Santiago, Chile

    Samuel Madariaga & Iván Plaza-Rosales

Authors
  1. Carla Arévalo-López
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  2. Silvia Gleitze
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  3. Samuel Madariaga
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  4. Iván Plaza-Rosales
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Contributions

IPR and CAL designed the study, wrote, and published the manuscript. SM reviewed the first draft of the manuscript. IPR and SG reviewed and edited the manuscript. IPR, CAL and SG prepared the manuscript for publication. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Iván Plaza-Rosales.

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The authors declare that they have no competing interests.

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Arévalo-López, C., Gleitze, S., Madariaga, S. et al. Pupillary response to chromatic light stimuli as a possible biomarker at the early stage of glaucoma: a review. Int Ophthalmol 43, 343–356 (2023). https://doi.org/10.1007/s10792-022-02381-8

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  • DOI: https://doi.org/10.1007/s10792-022-02381-8

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