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Concussion Alters Dynamic Pupillary Light Responses in Children
Jerry Hsu1,2,3, Magdalena Stec2,3, Hantamalala Ralay Ranaivo2
1Department of Ophthalmology, 12244Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Pediatric concussion alters dynamic pupillary responses, with faster constriction and dilation velocities observed. Pupillometry offers insights into concussion-related physiological changes in children.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Concussion, a common brain injury in children, can lead to visual disturbances.
- Pupillary function is a sensitive indicator of neurological status.
Purpose of the Study:
- To investigate the impact of concussion on pupillary function in children.
- To assess differences in pupillometric parameters between children with and without photosensitivity post-concussion.
Main Methods:
- Retrospective chart review of 92 pediatric patients with concussion and visual symptoms.
- Pupillometry data analyzed and compared to normative pediatric data.
- Linear mixed models used to assess the association between photosensitivity and pupillary responses.
Main Results:
- Concussion patients exhibited significantly faster average constriction velocity, maximum constriction velocity, and average dilation velocity compared to controls.
- A significant increase in 75% recovery time was observed in concussion patients.
- Photosensitivity did not significantly influence the measured pupillary responses.
Conclusions:
- Dynamic pupillary responses, including constriction and dilation velocities, appear altered in pediatric concussion.
- Pupillometry may serve as a valuable tool for understanding the pathophysiological changes associated with pediatric concussion.
Aim:
To investigate the impact of concussion on pupillary function in children by examining pupillometric parameters and assessing for differences in children reporting photosensitivity.
Methods:
Retrospective chart review was performed of pediatric patients referred for visual symptoms after concussion from 2017 to 2018 seen in a single academic outpatient clinic. Pupillometry data of 92 patients were included. Outcomes were compared to normative pediatric data from the same institution by 2-sample t tests. The association between photosensitivity and each outcome was assessed by use of linear mixed models with photosensitivity as a fixed effect and random patient effect.
Results:
Outcomes of 181 eyes in 92 concussion patients were averaged by patient and compared to normative values in scotopic conditions. Concussion patients had an average age of 13.8 ± 2.64 years. Average constriction velocity (P = .0008), maximum constriction velocity (P = .0012), and average dilation velocity (P = .0034) were faster in concussion patients, whereas 75% recovery times (P = .0027) was increased. Photosensitivity did not significantly affect measured pupillary responses.
Conclusion:
Dynamic pupillary responses may be increased in pediatric concussion. Pupillometry may provide insight into the complex pathophysiological changes underlying pediatric concussion.
