Assessing the Inter-Rater and Inter-Trial Reliability of the NeurOptics Pupillary Light Response-3000 Pupillometer

Area of Science:

• Ophthalmology
• Neurology
• Medical Devices

Background:

• Automated pupillometers measure pupillary light response (PLR) for objective brain injury assessment.
• Previous studies confirmed device validity, but inter-rater and inter-trial reliability remained unestablished.

Purpose of the Study:

• To evaluate the inter-rater and inter-trial reliability of the NeurOptics PLR-3000 pupillometer.
• To assess the reliability of measurements for pupil size, constriction, and dilation velocities.

Main Methods:

• An observational reliability study involving 48 healthy adults aged 18-40.
• Two independent raters utilized the NeurOptics PLR-3000 to measure PLR parameters.
• Reliability assessed using descriptive statistics, intraclass correlation coefficients (ICC), and Bland-Altman plots.

Main Results:

• Seven of eight parameters showed moderate-to-excellent inter-rater (ICC 0.72-0.96) and good-to-excellent inter-trial reliability (ICC 0.76-0.98).
• The 75% recovery time parameter demonstrated only moderate inter-rater (ICC 0.64-0.67) and poor-to-moderate inter-trial reliability (ICC 0.41-0.65).

Conclusions:

• The NeurOptics PLR-3000 is reliable for measuring pupil size, constriction/dilation velocity, and latency.
• The device's reliability is unacceptable for measuring 75% pupil recovery time.
• Clinicians should utilize only the reliable measures of the NeurOptics PLR-3000 for brain injury detection.