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Evaluation of Static Pupillary Parameters in Pediatric Patients with Vitamin B12 Deficiency
Z Y Öztorun1, G Y Biçer2, K R Zor2
1Department of Pediatrics, Niğde Ömer Halisdemir University School of Medicine, Niğde, Turkey.
Insights
Children with vitamin B12 deficiency (VB12D) show larger pupil sizes in moderate and bright light. This suggests autonomic dysfunction, impacting pupillary response in pediatric VB12D cases.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Vitamin B12 deficiency (VB12D) is linked to neurological issues, including autonomic dysfunction and ophthalmological disorders.
- Automatic pupillometry provides crucial data on pupillary function.
Purpose of the Study:
- To evaluate static pupillary functions in pediatric patients diagnosed with VB12D using automated pupillometry.
- To compare pupillary responses under varying light conditions between children with and without VB12D.
Main Methods:
- The study enrolled 40 children with VB12D and 40 healthy controls.
- Automated pupillometry was employed to measure static pupillary diameters under scotopic, mesopic, and photopic lighting.
- Statistical analysis was performed to compare pupillary measurements between the two groups.
Main Results:
- Children with VB12D exhibited significantly larger mean pupil diameters under mesopic (5.92 ± 0.69 mm vs. 5.18 ± 0.91 mm) and photopic (5.13 ± 0.77 mm vs. 4.53 ± 0.96 mm) conditions compared to controls.
- No significant difference in pupil diameter was observed under scotopic conditions (6.46 ± 0.68 mm vs. 6.37 ± 0.93 mm).
Conclusions:
- Pediatric VB12D is associated with enlarged pupils in mesopic and photopic environments, indicating impaired pupillary constriction.
- These findings suggest autonomic nervous system dysfunction, particularly affecting the parasympathetic system, in children with VB12D.
- Reduced pupillary myosis function is a notable observation in vitamin B12-deficient children.
Background:
Automatic pupillometry device enables important information about pupillary function. Neurological manifestations such as autonomic dysfunction and ophthalmological disorders are observed in vitamin B12 deficiency (VB12D).
Aim:
To assess the static pupillary functions using a pupillometry device in pediatric patients with VB12D.
Methods:
The study included 40 children with VB12D and 40 healthy children in the control group. The measurements were made with an automated pupillometry under static conditions. The static measurements were performed at scotopic, mesopic, and photopic light intensities. The differences between the patient and control groups were analyzed with static measurements.
Results:
Pupillary diameters of the patient and control groups under scotopic, mesopic, and photopic conditions were observed and there was a statistically significant difference under the mesopic and photopic conditions. Under mesopic conditions: The mean pupil diameter was found to be 5.92 ± 0.69 mm in the VB12D group and 5.18 ± 0.91 mm in the control group (P = 0.003). Under photopic conditions, the mean pupil diameter was found to be 5.13 ± 0.77 mm in the VB12D group and 4.53 ± 0.96 mm in the control group (P = 0.001). Under scotopic conditions, the mean pupil diameter was 6.46 ± 0.68 mm in the VB12D group and 6.37 ± 0.93 mm in the control group. There was no statistically significant difference between the patient and control groups in the measurements under scotopic conditions (P = 0.63).
Conclusion:
Pediatric patients with VB12D have significantly larger pupil diameters in photopic and mesopic conditions than healthy children. The results suggest that there is an autonomic system dysfunction in children with VB12D, especially when the parasympathetic system is negatively affected. Pupillary contraction is reduced in children with VB12D. Decreased pupillary myosis function is observed. Pupillary size is larger in vitamin B12-deficient children under photopic and mesopic conditions.
