ArticleBMC ophthalmology2025
Correlation between pupillary light reflex (PLR) amplitude and visual function in primary angle-closure glaucoma: a retrospective clinical study.
Article in BMC ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study investigated the correlation between pupillary light reflex (PLR) amplitude and visual impairment severity in primary angle-closure glaucoma (PACG).
methodsThis retrospective case-control study included 35 eyes of 35 PACG patients and 15 eyes of 15 age-/sex-matched controls. Pupillary parameters (photopic/scotopic diameters, PLR amplitude) were measured using the OPD-Scan III wavefront aberrometer. Clinical metrics included best-corrected visual acuity (BCVA), the cup-to-disc ratio (C/D), the visual field mean deviation (MD), and retinal nerve fiber layer thickness (RNFLT) across six optic disc quadrants. Patients were stratified into mild (MD ≥ -6 dB), moderate (-12 dB ≤ MD < -6 dB), and severe (MD < -12 dB) subgroups per HPA criteria.
resultsCompared to controls, PACG patients showed significantly reduced PLR amplitude and scotopic diameter (P < 0.001 and P = 0.013, respectively). Significant inter-subgroup differences were observed in PLR amplitude (mild vs. severe; moderate vs. severe) (all P < 0.001). Significant inter-subgroup differences were observed in MD (mild vs. severe: P < 0.001; moderate vs. mild: P = 0.010;moderate vs. severe: P = 0.032), BCVA (mild vs. severe: P = 0.005), C/D (mild vs. severe: P < 0.001; moderate vs. severe: P = 0.013), and average RNFLT (mild vs. severe: P < 0.001; moderate vs. severe: P = 0.032). PLR amplitude negatively correlated with C/D (r=-0.706, P < 0.001) and positively with MD (r = 0.746), nasal (r = 0.527), superonasal (r = 0.449), inferonasal (r = 0.513),Temporal(r = 0.475)inferotemporal(r = 0.483),and average RNFLT (r = 0.526) (all P < 0.05). Multivariable linear regression analysis revealed that only MD was independently associated with PLR amplitude (β = 0.040, P < 0.001) after adjusting for age, IOP, BCVA, ACD, and IT750.
conclusionReduced PLR amplitude in PACG correlates with structural and functional deterioration, reflecting disease severity. As a rapid, non-invasive metric, PLR assessment complements conventional methods for objective PACG evaluation.
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