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Dynamic pupillometry as an autonomic testing tool.

Srikanth Muppidi1, Beverley Adams-Huet, Emil Tajzoy

  • 1Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hives Blvd, Dallas, TX, 75390-9129, USA, srikanth.muppidi@utsouthwestern.edu.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 25, 2013
PubMed
Summary
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Pupillometry reveals distinct differences in pupil response between healthy individuals and those with autonomic dysfunction. Key parasympathetic and sympathetic indices are altered in patients with moderate to severe autonomic failure.

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Autonomic Function Testing

Background:

  • Pupillometry measures autonomic nervous system function via pupil responses.
  • Autonomic dysfunction can impact various physiological processes, including pupillary reflexes.

Purpose of the Study:

  • Establish normative pupillometry values in healthy subjects.
  • Investigate pupillometry indices in patients with varying degrees of autonomic dysfunction.

Main Methods:

  • Infrared video pupillometry assessed pupil response to light flashes.
  • Study included 79 healthy controls and 54 patients with autonomic dysfunction (CASS < 2 or CASS > 4).
  • Analyzed eight indices of parasympathetic and sympathetic pupil function, adjusting for age.

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Main Results:

  • Parasympathetic indices (MCV, ACA) were significantly lower in patients with high CASS scores.
  • Sympathetic dysfunction was suggested by a higher T¾:ACA ratio in the high CASS group.
  • Age negatively correlated with baseline pupil diameter, maximum constriction velocity, absolute constriction amplitude, and maximum dilation velocity.

Conclusions:

  • Pupillomotor function indices are significantly different in patients with moderate to severe autonomic failure compared to healthy controls.
  • Pupillometry is a valuable tool for assessing autonomic dysfunction.