Abstract

Diabetes is a familiar disease in modern society. In the early stage of diabetes, symptoms are unobvious, but they usually induce diabetic autonomic neuropathy or, worse, cardiovascular autonomic neuropathy. Pupillometers are effective instruments for observing human pupils. This article presents a novel wearable pupillometer design, without external light artifacts, and an embedded algorithm with blinking elimination, which investigates autonomic neuropathy through recording pupil dynamics triggered by an external sensitive invisible light source. The pupillometer is experimented on 36 healthy subjects and 10 diabetic patients under four different colors (white, red, green, and blue) as well as two different light intensities: 50 and 500 mcd. Ten parameters derived from pupil diameter, pupil response time, and pupil response speed will be evaluated for the healthy subjects and diabetic patients. The results show that three in four parameters related to pupil diameters, one in four related to light intensities, and one in two related to pupil response speed could have significant differences (p<0.05) between healthy subjects and diabetic patients. These parameters obtain over 85% sensitivity, 83% specificity, and 88% accuracy. The pupillometer is proven reliable, effective, portable, and inexpensive for diagnosing diabetes in an early stage.

© 2014 Optical Society of America

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References

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  1. A. I. Vinik and T. Erbas, “Recognizing and treating diabetic autonomic neuropathy,” Cleve. Clin. J. Med. 68, 928–944 (2001).
    [CrossRef]
  2. A. I. Vinik and D. Ziegler, “Diabetic cardiovascular autonomic neuropathy,” Circulation 115, 387–397 (2007).
    [CrossRef]
  3. American Diabetes Association and American Academy of Neurology, “Report and recommendations of the San Antonio conference on diabetic neuropathy (consensus statement),” Diabetes 37, 1000–1004 (1988).
    [CrossRef]
  4. A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
    [CrossRef]
  5. D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).
  6. A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
    [CrossRef]
  7. UKPDS—United Kingdom Prospective Diabetes Study Group, “Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study,” British Med. J. 321, 405–412 (2000).
    [CrossRef]
  8. D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
    [CrossRef]
  9. M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).
  10. G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).
  11. G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.
  12. L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
    [CrossRef]
  13. G. Leal, C. Neves, and P. M. Vieira, “Pupillometry: development of equipment for studies of autonomic nervous system,” in Technological Innovation for Value Creation, Vol. 372 of International Federation for Information Processing Advances in Information and Communication Technology (Springer, 2012), pp. 553–562.
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    [CrossRef]

2011

2010

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
[CrossRef]

2007

A. I. Vinik and D. Ziegler, “Diabetic cardiovascular autonomic neuropathy,” Circulation 115, 387–397 (2007).
[CrossRef]

2005

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

2003

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

2002

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

J. O. D. Richman and R. S. Noriega, “The sensitivity and specificity of infared pupillometry measurement in identifying drug impairment in a county probation program,” Opto. Vis. Sci. 79, 232–234 (2002).
[CrossRef]

2001

A. I. Vinik and T. Erbas, “Recognizing and treating diabetic autonomic neuropathy,” Cleve. Clin. J. Med. 68, 928–944 (2001).
[CrossRef]

2000

UKPDS—United Kingdom Prospective Diabetes Study Group, “Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study,” British Med. J. 321, 405–412 (2000).
[CrossRef]

1997

1990

1988

American Diabetes Association and American Academy of Neurology, “Report and recommendations of the San Antonio conference on diabetic neuropathy (consensus statement),” Diabetes 37, 1000–1004 (1988).
[CrossRef]

1980

D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).

A. Cohen, C. Acquista, and J. A. Cooney, “Extinction of light by large reflecting spheres,” Appl. Opt. 19, 2264–2265 (1980).
[CrossRef]

1971

Acquista, C.

Arezzo, J. C.

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

Baba, T.

Bacchetti, P.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Behrens-Baumann, W.

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

Boulton, A. J.

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

Bril, V.

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

Campbell, I. W.

D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).

Carroll, J.

Clarke, B. F.

D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).

Cohen, A.

Cooney, J. A.

Cooper, R. F.

Du, R.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Dubis, A. M.

Dubra, A.

Emery, C. J.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Erbas, T.

A. I. Vinik and T. Erbas, “Recognizing and treating diabetic autonomic neuropathy,” Cleve. Clin. J. Med. 68, 928–944 (2001).
[CrossRef]

Ewing, D. J.

D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).

Ferrari, G. L.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Freeman, R.

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

Gamba, H. R.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Gamlin, P. D.

L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
[CrossRef]

Gandhi, R. A.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Girkin, C. A.

L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
[CrossRef]

Heller, S. R.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Hirano, M.

Holland, M. C.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Kankipati, L.

L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
[CrossRef]

Kattawar, G. W.

Kokubun, Y.

Larson, M. D.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Leal, G.

G. Leal, C. Neves, and P. M. Vieira, “Pupillometry: development of equipment for studies of autonomic nervous system,” in Technological Innovation for Value Creation, Vol. 372 of International Federation for Information Processing Advances in Information and Communication Technology (Springer, 2012), pp. 553–562.

Lehnert, H.

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

Lobmann, R.

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

Manley, G.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Marques, J. L. B.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Maser, R. E.

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

Meeker, M.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Mitchell, B. D.

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

Mizukami, M.

Neves, C.

G. Leal, C. Neves, and P. M. Vieira, “Pupillometry: development of equipment for studies of autonomic nervous system,” in Technological Innovation for Value Creation, Vol. 372 of International Federation for Information Processing Advances in Information and Communication Technology (Springer, 2012), pp. 553–562.

Noriega, R. S.

J. O. D. Richman and R. S. Noriega, “The sensitivity and specificity of infared pupillometry measurement in identifying drug impairment in a county probation program,” Opto. Vis. Sci. 79, 232–234 (2002).
[CrossRef]

Norris, J. L.

Ohira, F.

Pittasch, D.

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

Plass, G. N.

Privitera, C. M.

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Richman, J. O. D.

J. O. D. Richman and R. S. Noriega, “The sensitivity and specificity of infared pupillometry measurement in identifying drug impairment in a county probation program,” Opto. Vis. Sci. 79, 232–234 (2002).
[CrossRef]

Schneider, F. K.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Sulai, Y.

Tesfaye, S.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

Vieira, P. M.

G. Leal, C. Neves, and P. M. Vieira, “Pupillometry: development of equipment for studies of autonomic nervous system,” in Technological Innovation for Value Creation, Vol. 372 of International Federation for Information Processing Advances in Information and Communication Technology (Springer, 2012), pp. 553–562.

Vinik, A. I.

A. I. Vinik and D. Ziegler, “Diabetic cardiovascular autonomic neuropathy,” Circulation 115, 387–397 (2007).
[CrossRef]

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

A. I. Vinik and T. Erbas, “Recognizing and treating diabetic autonomic neuropathy,” Cleve. Clin. J. Med. 68, 928–944 (2001).
[CrossRef]

Williams, D. R.

Ziegler, D.

A. I. Vinik and D. Ziegler, “Diabetic cardiovascular autonomic neuropathy,” Circulation 115, 387–397 (2007).
[CrossRef]

Appl. Opt.

Biomed. Opt. Express

BioMedical Eng. OnLine

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, S. R. Heller, F. K. Schneider, S. Tesfaye, and H. R. Gamba, “Using dynamic pupillometery as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study,” BioMedical Eng. OnLine 9, 1–16 (2010).

British Med. J.

UKPDS—United Kingdom Prospective Diabetes Study Group, “Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study,” British Med. J. 321, 405–412 (2000).
[CrossRef]

Circulation

A. I. Vinik and D. Ziegler, “Diabetic cardiovascular autonomic neuropathy,” Circulation 115, 387–397 (2007).
[CrossRef]

Cleve. Clin. J. Med.

A. I. Vinik and T. Erbas, “Recognizing and treating diabetic autonomic neuropathy,” Cleve. Clin. J. Med. 68, 928–944 (2001).
[CrossRef]

Diabetes

American Diabetes Association and American Academy of Neurology, “Report and recommendations of the San Antonio conference on diabetic neuropathy (consensus statement),” Diabetes 37, 1000–1004 (1988).
[CrossRef]

Diabetes Care

A. J. Boulton, A. I. Vinik, J. C. Arezzo, and V. Bril, “Diabetic neuropathies: a statement by the American Diabetes Association,” Diabetes Care 28, 956–962 (2005).
[CrossRef]

A. I. Vinik, R. E. Maser, B. D. Mitchell, and R. Freeman, “Diabetic autonomic neuropathy,” Diabetes Care 26, 1553–1579 (2003).
[CrossRef]

D. Pittasch, R. Lobmann, W. Behrens-Baumann, and H. Lehnert, “Pupil signs of sympathetic autonomic neuropathy in patients with type 1 diabetes,” Diabetes Care 25, 1545–1550 (2002).
[CrossRef]

Investig. Ophthalmol. Vis. Sci.

L. Kankipati, C. A. Girkin, and P. D. Gamlin, “Post-illumination pupil response in subjects without ocular disease,” Investig. Ophthalmol. Vis. Sci. 51, 2764–2769 (2010).
[CrossRef]

J. Neurosci. Nursing

M. Meeker, R. Du, P. Bacchetti, C. M. Privitera, M. D. Larson, M. C. Holland, and G. Manley, “Pupil: examination: validity and clinical utility of an automated pupillometer,” J. Neurosci. Nursing 37, 34–40 (2005).

Opto. Vis. Sci.

J. O. D. Richman and R. S. Noriega, “The sensitivity and specificity of infared pupillometry measurement in identifying drug impairment in a county probation program,” Opto. Vis. Sci. 79, 232–234 (2002).
[CrossRef]

Q. J. Med.

D. J. Ewing, I. W. Campbell, and B. F. Clarke, “The natural history of diabetic autonomic neuropathy,” Q. J. Med. 49, 95–108 (1980).

Other

G. Leal, C. Neves, and P. M. Vieira, “Pupillometry: development of equipment for studies of autonomic nervous system,” in Technological Innovation for Value Creation, Vol. 372 of International Federation for Information Processing Advances in Information and Communication Technology (Springer, 2012), pp. 553–562.

G. L. Ferrari, J. L. B. Marques, R. A. Gandhi, C. J. Emery, S. Tesfaye, S. R. Heller, F. K. Schneider, and H. R. Gamba, “An approach to the assessment of diabetic neuropathy based on dynamic pupillometer,” in IEEE Engineering in Medicine and Biology Society (EMBS 2007) 29th Annual International Conference of the IEEE, August22–26, 2007, pp. 557–560.

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Figures (10)

Fig. 1.
Fig. 1.

Block diagram of pupillometer.

Fig. 2.
Fig. 2.

Assembly drawing of pupillometer.

Fig. 3.
Fig. 3.

Rays propagation diagram: La=20mm; Lb=10mm; Lc=25mm; Ld=45mm; Le=48mm.

Fig. 4.
Fig. 4.

Optical design for reducing the reflection of LED light spots from IR LEDs. The eye radius is R (12 mm). The distance between the eye and lens is L. The field-of-view angle is Φ (13°). The distance between the IR LED and CCD is H (10 mm). The distance between the reflective path and the CCD is D.

Fig. 5.
Fig. 5.

Experimental apparatus of pupillometer.

Fig. 6.
Fig. 6.

Relationship between distance L and distance D.

Fig. 7.
Fig. 7.

Block diagram of image processing.

Fig. 8.
Fig. 8.

Pupil image processing with several blinks. (a) Raw data obtained with blinking. (b) Data eliminated part of blinking. (c) Resulting data obtained by interpolating. (d) Comparison between (a) and (c).

Fig. 9.
Fig. 9.

Definitions of various pupil parameters: 1. Resting pupil diameter in dark. 2. Minimum pupil diameter. 3. Restore to 75% pupil diameter. 4. Reflex amplitude. 5. Latency to constriction. 6. Duration of resting pupil’s constriction to minimum pupil size. 7. Duration between the minimum pupil size restoring to the 75% pupil size. 8. Duration between the resting size and restoration to the 75% pupil size. 9. Maximum pupil constriction velocities. 10. Maximum pupil restoration velocities.

Fig. 10.
Fig. 10.

Gaussian distribution of the experimental results. (a) healthy subjects. (b) diabetic patients. A, B, C, and D parameters are the areas under the curve.

Tables (6)

Tables Icon

Table 1. Specifications of Beam Splitter

Tables Icon

Table 2. Specifications of Stimulating LEDs

Tables Icon

Table 3. Mean and Standard Deviation of Resultsa

Tables Icon

Table 4. Chi-Squared Test Between Diabetes and Health Under Different Light Intensities and Color of Stimulationsa

Tables Icon

Table 5. Comparison of Diabetic Patients and Healthy Subjects Without Light Intensity and Color Classificationa

Tables Icon

Table 6. Comparison of Various Pupillometers

Equations (7)

Equations on this page are rendered with MathJax. Learn more.

x2+y2=R2,
y=(tanΦ)[x(R+L)],
θ=tan1(x/y).
D=tan(2θ+Φ)[L+(Rx)]+y.
Sensitivity=A/(A+B),
Specificity=C/(C+D),
Accuracy=(A+C)/(A+B+C+D).

Metrics