The Detection of Glaucoma Using Pupillography (RAPiD)

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
David S. Friedman, Johns Hopkins University Identifier:
First received: October 27, 2011
Last updated: November 12, 2015
Last verified: November 2015

Current screening methods for glaucoma detection are not perfect and nearly half of those in the United States with glaucoma go undiagnosed. Minority populations are even less likely to be diagnosed. Better screening methods are needed to identify the undiagnosed and to provide them care that can help them retain good vision.

Glaucoma is often more severe in one eye and this fact can be exploited in screening tests. The investigators plan to use a novel screening device that very accurately records the pupillary response from each eye. It is likely that patients with glaucoma will have abnormal responses when measured, and by comparing responses between the two eyes the investigators will be able to determine who has glaucoma. If this test works well, it will provide a low-cost way to screen populations at risk for glaucoma. Furthermore, this research will expand the knowledge base regarding how pupil responses to light differ between persons with and without glaucoma. Insights gained from this study will be useful in the development of an effective screening tool in the detection of glaucoma.


Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: The Detection of Glaucoma Using Pupillography

Resource links provided by NLM:

Further study details as provided by Johns Hopkins University:

Estimated Enrollment: 645
Study Start Date: March 2011
Estimated Study Completion Date: September 2017
Estimated Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)

Detailed Description:

Glaucoma is often asymmetric in nature, and an afferent pupillary defect (APD) is frequently present in persons with glaucoma. The investigators propose to conduct a clinic-based prospective study to assess the accuracy of using a binocular pupillographic device (RAPiD, Konan Medical, USA) to detect people with glaucoma. This device is designed to record and analyze pupil responses at multiple, controlled stimulus intensities, while using varied patterns and color stimuli.

The asymmetric nature of glaucoma suggests that a high proportion of persons with glaucoma will have an APD (although many may be subtle and would be missed with less refined testing methods). When glaucoma patients have severe nerve damage or when field loss is bilateral and symmetric, an APD may not be present or may be too small to detect. Noting this limitation, the investigators will compare pupillary responses to stimuli at different locations (for example the superior compared to the inferior hemifield) to determine whether the investigators can detect asymmetric glaucoma damage within the same eye. In addition, it is likely that the pupil response in glaucoma will be diminished when compared to normal, which will also help with detection.

Aim1: To examine the amplitude, latency and velocity of the pupil light reflex by optimizing its measurement to stimuli of various intensities and colors, and to characterize the variability of this response in normal subjects.

Aim2: To quantify the amount of structural loss (retinal nerve fiber layer thickness and optic nerve head parameters) and functional loss (visual field mean deviation) necessary for an APD (as detected by RAPiD) to manifest.

Aim3a: To develop an algorithm that best discriminates those with and without glaucoma by individual or combined use of 1) detecting an APD between the two eyes, 2) comparing pupil responses in different parts of the visual field within the same eye, and 3) comparing responses of diseased eyes to responses of "normal" eyes.

Aim 3b: To assess the validity of this algorithm in glaucoma detection and to assess the reproducibility of the pupil response measurements at a follow-up visit within 7 months.


Ages Eligible for Study:   40 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Patients with glaucoma, glaucoma suspects, or ocular hypertension who present to the glaucoma service at the Johns Hopkins Wilmer Eye Institute. We will also recruit normal subjects from the accompanying persons of patients attending examinations who are not blood relatives of the patient.

Inclusion Criteria:

  • Age 40 years or older at enrollment
  • Presenting visual acuity better than 20/100 in both eyes
  • Spherical equivalent refractive error within the range of 4.0 and -6.0 diopters in both eyes

Exclusion Criteria:

  • Ocular surgery in either eye within 3 months
  Contacts and Locations
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Please refer to this study by its identifier: NCT01462526

United States, Maryland
Wilmer Eye Institute Johns Hopkins University
Baltimore, Maryland, United States, 21287
Sponsors and Collaborators
Johns Hopkins University
Principal Investigator: David S Friedman, MD Johns Hopkins University
  More Information

No publications provided

Responsible Party: David S. Friedman, Professor, Johns Hopkins University Identifier: NCT01462526     History of Changes
Other Study ID Numbers: NA_00044899
Study First Received: October 27, 2011
Last Updated: November 12, 2015
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Eye Diseases
Ocular Hypertension processed this record on November 30, 2015