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Association between dynamic pupil parameters and corneal sub-basal nerve plexus morphology
Wenyan Zhou1,2, Zhiyu Zhang1, Haozhe Yu1
1Department of Ophthalmology, Peking University First Hospital, Beijing, China.
Documenta Ophthalmologica. Advances in Ophthalmology
|June 27, 2026
Summary
In immune-related dry eye disease, reduced corneal nerves correlate with impaired pupil responses. Dynamic pupillometry offers functional insights into corneal nerve damage.
Area of Science:
- Ophthalmology
- Neuroscience
Background:
- Dry eye disease (DED) significantly impacts ocular surface health.
- Immune-related DED involves complex inflammatory processes affecting corneal nerves.
- Corneal nerve alterations can manifest in functional deficits.
Purpose of the Study:
- To investigate the relationship between dynamic pupillometry measures and corneal sub-basal nerve morphology in immune-related DED.
- To assess if pupillary reflex parameters correlate with in vivo confocal microscopy (IVCM)-derived nerve metrics.
Main Methods:
- Cross-sectional study of 28 patients with immune-related DED.
- IVCM used to quantify corneal nerve fiber length density (CNFL), intensity, and tortuosity.
- Automated pupillometry measured dynamic pupillary light reflexes (pupil size, constriction/dilation velocities).
Main Results:
- Significant positive correlations found between CNFL and baseline pupil size, recovery pupil size, and total contraction/dilation time.
- CNFL independently predicted baseline pupil diameter, even after adjusting for age and gender.
Conclusions:
- Structural changes in corneal nerves are reflected in functional pupillary dynamics.
- Dynamic pupillometry may serve as a complementary tool to assess corneal nerve alterations in immune-related DED.
