AI Insight
This study evaluated a virtual reality headset (HP Reverb G2 Omnicept) for detecting pupillary abnormalities in 29 patients with optic nerve or pupil disorders compared to 19 healthy controls. VR pupillometry matched conventional examination in detecting relative afferent pupillary defect (RAPD) in 16 of 21 optic neuropathy patients and was superior in detecting pathological anisocoria (unequal pupil size), identifying it in 7 of 8 suspected cases versus only 1 of 8 by standard exam. The technology showed strong correlations between pupillary defects and visual function measurements, with all patients having greater than 5.8 dB inter-eye visual field difference showing RAPD.
Why it matters
VR-based pupillometry offers an objective, quantitative alternative to subjective clinical pupil examination, potentially improving detection of neurological and ophthalmological conditions. The technology could enable more precise monitoring of patients in clinical practice and research studies, while also providing longitudinal data on pupillary characteristics that are difficult to capture with conventional examination methods.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Purpose: Pupil examination is a routine examination of patients presenting with ophthalmological or neurological symptoms. Our purpose was to determine the sensitivity of pupillometry using HP Reverb G2 Omnicept virtual reality (VR) headset for detecting anisocoria and relative afferent pupillary defect (RAPD). Methods: Twenty-nine patients were included; Group I with asymmetric optic neuropathy (N=21) and Group II with suspected pathological anisocoria (N=8); alongside 19 controls. VR pupillometry consisted of Pupil symmetry test and Swinging light test. Pathological thresholds were established using upper limits of controls. Results were compared with routine pupil exam. Correlations with functional ophthalmological test results were analyzed. Results: RAPD was detected in 16/21 Group 1 patients using both VR pupillometry and standard exam. Remaining 5 had relative afferent pupillary asymmetry (RAPA) within the control range (0.1-0.2 mm). Significant correlation was found between RAPA/RAPD and inter-eye difference in visual acuity and visual field defect (MD) (R=0.58 and 0.68, p<0.01). All patients with >5,8 dB inter-eye MD difference had RAPD. In Group II, pathological anisocoria (>0.8 mm) was detected using VR pupillometry and 1/8 on standard exam. Qualitative differences in pupillary constriction were observed. In control group anisocoria (0.4-0.8 mm) was detected in 37% (7/19); in all greater in the dark (mean 0.2 mm). Conclusion: In comparison to conventional exam VR pupillometry matched detection rate of RAPD and surpassed detection rate of pathological anisocoria. Longitudinal data on pupillary constriction characteristics could significantly contribute to patient diagnosis and monitoring in clinical studies as well as understanding physiological variability.