Individual Differences in the Post-Illumination Pupil Response to Blue Light: Assessment without Mydriatics

Jessica Bruijel, Wisse P van der Meijden, Denise Bijlenga, Farangis Dorani, Joris E Coppens, Bart H W Te Lindert, Sandra Kooij, Eus J W Van Someren

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Melanopsin-containing retinal ganglion cells play an important role in the non-image forming effects of light, through their direct projections on brain circuits involved in circadian rhythms, mood and alertness. Individual differences in the functionality of the melanopsin-signaling circuitry can be reliably quantified using the maximum post-illumination pupil response (PIPR) after blue light. Previous protocols for acquiring PIPR relied on the use of mydriatics to dilate the light-exposed eye. However, pharmacological pupil dilation is uncomfortable for the participants and requires ophthalmological expertise. Hence, we here investigated whether an individual's maximum PIPR can be validly obtained in a protocol that does not use mydriatics but rather increases the intensity of the light stimulus. In 18 participants (5 males, mean age ± SD: 34.6 ± 13.6 years) we evaluated the PIPR after exposure to intensified blue light (550 µW/cm²) provided to an undilated dynamic pupil. The test-retest reliability of the primary PIPR outcome parameter was very high, both between day-to-day assessments (Intraclass Correlation Coefficient (ICC) = 0.85), as well as between winter and summer assessments (ICC = 0.83). Compared to the PIPR obtained with the use of mydriatics and 160 µW/cm² blue light exposure, the method with intensified light without mydriatics showed almost zero bias according to Bland-Altman plots and had moderate to strong reliability (ICC = 0.67). In conclusion, for PIPR assessments, increasing the light intensity is a feasible and reliable alternative to pupil dilation to relieve the participant's burden and to allow for performance outside the ophthalmological clinic.

Original languageEnglish
JournalBiology
Volume5
Issue number3
DOIs
Publication statusPublished - 9 Sep 2016

Cite this

Bruijel, Jessica ; van der Meijden, Wisse P ; Bijlenga, Denise ; Dorani, Farangis ; Coppens, Joris E ; Te Lindert, Bart H W ; Kooij, Sandra ; Van Someren, Eus J W. / Individual Differences in the Post-Illumination Pupil Response to Blue Light : Assessment without Mydriatics. In: Biology. 2016 ; Vol. 5, No. 3.
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Individual Differences in the Post-Illumination Pupil Response to Blue Light : Assessment without Mydriatics. / Bruijel, Jessica; van der Meijden, Wisse P; Bijlenga, Denise; Dorani, Farangis; Coppens, Joris E; Te Lindert, Bart H W; Kooij, Sandra; Van Someren, Eus J W.

In: Biology, Vol. 5, No. 3, 09.09.2016.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Individual Differences in the Post-Illumination Pupil Response to Blue Light

T2 - Assessment without Mydriatics

AU - Bruijel, Jessica

AU - van der Meijden, Wisse P

AU - Bijlenga, Denise

AU - Dorani, Farangis

AU - Coppens, Joris E

AU - Te Lindert, Bart H W

AU - Kooij, Sandra

AU - Van Someren, Eus J W

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N2 - Melanopsin-containing retinal ganglion cells play an important role in the non-image forming effects of light, through their direct projections on brain circuits involved in circadian rhythms, mood and alertness. Individual differences in the functionality of the melanopsin-signaling circuitry can be reliably quantified using the maximum post-illumination pupil response (PIPR) after blue light. Previous protocols for acquiring PIPR relied on the use of mydriatics to dilate the light-exposed eye. However, pharmacological pupil dilation is uncomfortable for the participants and requires ophthalmological expertise. Hence, we here investigated whether an individual's maximum PIPR can be validly obtained in a protocol that does not use mydriatics but rather increases the intensity of the light stimulus. In 18 participants (5 males, mean age ± SD: 34.6 ± 13.6 years) we evaluated the PIPR after exposure to intensified blue light (550 µW/cm²) provided to an undilated dynamic pupil. The test-retest reliability of the primary PIPR outcome parameter was very high, both between day-to-day assessments (Intraclass Correlation Coefficient (ICC) = 0.85), as well as between winter and summer assessments (ICC = 0.83). Compared to the PIPR obtained with the use of mydriatics and 160 µW/cm² blue light exposure, the method with intensified light without mydriatics showed almost zero bias according to Bland-Altman plots and had moderate to strong reliability (ICC = 0.67). In conclusion, for PIPR assessments, increasing the light intensity is a feasible and reliable alternative to pupil dilation to relieve the participant's burden and to allow for performance outside the ophthalmological clinic.

AB - Melanopsin-containing retinal ganglion cells play an important role in the non-image forming effects of light, through their direct projections on brain circuits involved in circadian rhythms, mood and alertness. Individual differences in the functionality of the melanopsin-signaling circuitry can be reliably quantified using the maximum post-illumination pupil response (PIPR) after blue light. Previous protocols for acquiring PIPR relied on the use of mydriatics to dilate the light-exposed eye. However, pharmacological pupil dilation is uncomfortable for the participants and requires ophthalmological expertise. Hence, we here investigated whether an individual's maximum PIPR can be validly obtained in a protocol that does not use mydriatics but rather increases the intensity of the light stimulus. In 18 participants (5 males, mean age ± SD: 34.6 ± 13.6 years) we evaluated the PIPR after exposure to intensified blue light (550 µW/cm²) provided to an undilated dynamic pupil. The test-retest reliability of the primary PIPR outcome parameter was very high, both between day-to-day assessments (Intraclass Correlation Coefficient (ICC) = 0.85), as well as between winter and summer assessments (ICC = 0.83). Compared to the PIPR obtained with the use of mydriatics and 160 µW/cm² blue light exposure, the method with intensified light without mydriatics showed almost zero bias according to Bland-Altman plots and had moderate to strong reliability (ICC = 0.67). In conclusion, for PIPR assessments, increasing the light intensity is a feasible and reliable alternative to pupil dilation to relieve the participant's burden and to allow for performance outside the ophthalmological clinic.

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JF - Biology

SN - 2079-7737

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Bruijel J, van der Meijden WP, Bijlenga D, Dorani F, Coppens JE, Te Lindert BHW et al. Individual Differences in the Post-Illumination Pupil Response to Blue Light: Assessment without Mydriatics. Biology. 2016 Sep 9;5(3). https://doi.org/10.3390/biology5030034