Chromatic Pupil Campimetry Reveals Functional Defects in Exudative Age-Related Macular Degeneration with Differences Related to Disease Activity

PURPOSE: The purpose of this study was to use chromatic pupil campimetry (CPC) for an objective evaluation of local retinal function in exudative age-related macular degeneration (AMD) and to assess disease activity. METHODS: Gaze-controlled CPC was performed in 19 subjects with optical coherence tomography–confirmed exudative AMD (75 ± 4 years; 11 women) and the results compared with those of an age-matched control group (n = 11; 72 ± 6 years; 8 women). Local retinal function was evaluated by measuring pupil responses to 3° red stimuli (60 cd/m(2), 1 second) at 41 positions covering 30° of the central visual field on a dim blue background (test duration 6 minutes). Primary outcome parameters were relative maximal pupil constriction amplitude (% from baseline) and latency to constriction onset. RESULTS: Pupil constriction amplitudes were significantly reduced in the macular region, and especially in the fovea in AMD (16% ± 4.7%; mean ± standard deviation), compared with the control group (24% ± 6%; P = 0.00036). Receiver operating characteristic values were 0.84 for the constriction amplitude in the fovea, and 0.9 for the steepness angle between periphery and center. Mean latency to constriction onset in the fovea in AMD was significantly longer (333 ± 53 ms; normals 273 ± 59 ms, P = 0.0072), and particularly in the active compared with the inactive status of exudative AMD (P = 0.01). CONCLUSIONS: CPC detected functional changes in exudative AMD with high sensitivity. Time dynamics of active exudative AMD differed from disease inactivity. TRANSLATIONAL RELEVANCE: With the combination of short recording time, objectiveness of the measurement and gaze-correction for fixation problems, this method presents a suitable complement to the currently used clinical functional tests of the macula.