Authors: Zhou, X., Fukuyama, H., Okita, Y., Kanda, H., Yamamoto, Y., Araki, T., & Gomi, F. Journal: Investigative Ophthalmology & Visual Science
Central serous chorioretinopathy (CSC) is a retinal disorder characterized by detachment of the posterior macula, resulting in vision disturbances or even vision loss if left untreated. Among various disease-contributing factors, high cortisol levels and chronic stress can precipitate the disease onset.
The stress response involves the autonomic nervous system, which consists of two primary branches – the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). It is thought that the autonomous nervous system might be imbalanced in individuals with CSC, characterized by elevated SNS activity and inhibition of PNS. Autonomic nervous system pathway activation can be noninvasively assessed by measuring heart rate variability and pupillary response.
In this study, Zhou and colleagues opted to assess the autonomic nervous system activity in patients with CSC, using pupillary responses combined with heart rate variability measures.
The study participants’ pupillary light reflex, pupillary responses during three mental tasks, and heart rate variability were analyzed. The pupillary responses were measured using Tobii Pro Spectrum, and Tobii Pro Lab software was used to set up the experiment, present the stimulus, conduct qualitative data analysis, and visualize the data.
The study authors found a few key differences between CSC-affected individuals and healthy controls. When compar- ing the two groups, CSC patients showed a reduction in pupillary constriction amplitude during a bright light stimulus, increased pupil re-dilation after a bright light stimulus
and larger pupil dilation during mental tasks of mod- erate difficulty. These results and combined simulta- neous heart rate variability measurements confirmed that CSC patients experience increased SNS and de- creased PNS activity compared to healthy individuals.
In conclusion, by measuring pupillary responses and heart rate variability, Zhou and colleagues confirmed the autonomic nervous system differences in individ- uals with CSC. The pupillary light response and mental task-evoked pupillary responses could be used for CSC screening and diagnostics. Moreover, these findings might also contribute to developing more effective treatments and preventive measures for CSC disease