Kuijpers Kiki W K, Andersson Karl, Dahan Albert, Hämäläinen Markku D, van Velzen Monique
Department of Anesthesiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Skillsta Teknik Design och Kvalitet AB, Vänge, SE75578 Uppsala, Sweden.
Sensors (Basel). 2025 Sep 3;25(17):5467. doi: 10.3390/s25175467.
Opioids are known to constrict pupils, and mobile phone-based self-administered eye scanning (MPSES) offers a potential method for monitoring opioid use in real-world settings. A clinical trial with 12 volunteers measured pupil size using MPSES under different light conditions (approx. 50 or approx. 500 lux) in the lab and over a week at home. Each participant made approximately 21 home tests, 12 in the lab without oxycodone and 16 in the lab after oxycodone intake. At the second visit the participants received a single dose of 20 mg oxycodone, and their pupil size was monitored hourly for 5 h. The pupil size after oxycodone intake was compared to drug-naïve tests performed at the lab and at home. Logistic regression models were built using measured pupil size and light conditions measured by the phone during each test, and a dichotomous variable indicating tests before or after oxycodone dosing as the outcome. The model demonstrated high classification accuracy (AUC = 0.94), with 82% true positives, 9% false positives, 91% true negatives and 18% false negatives. Misclassifications were largely due to difficulties measuring pupil size in individuals with corneal arcus, causing most of the false positive findings, and other interindividual differences. This shows that MPSES, including monitoring of ambient light conditions, can effectively detect opioid use within the 50-500 lux range. Our study paves the way for using MPSES to detect opioid use.
众所周知，阿片类药物会使瞳孔收缩，而基于手机的自我管理眼部扫描（MPSES）为在现实环境中监测阿片类药物使用情况提供了一种潜在方法。一项针对12名志愿者的临床试验，在实验室不同光照条件下（约50勒克斯或约500勒克斯）以及在家中为期一周的时间里，使用MPSES测量瞳孔大小。每位参与者在家中进行了约21次测试，在实验室进行了12次未服用羟考酮时的测试以及16次服用羟考酮后的测试。在第二次就诊时，参与者服用了一剂20毫克的羟考酮，并在5小时内每小时监测一次他们的瞳孔大小。将服用羟考酮后的瞳孔大小与在实验室和家中进行的未服用药物时的测试结果进行比较。使用每次测试期间通过手机测量的瞳孔大小和光照条件建立逻辑回归模型，并将一个二分变量作为结果，该变量指示羟考酮给药之前或之后的测试。该模型显示出较高的分类准确率（AUC = 0.94），真阳性率为82%，假阳性率为9%，真阴性率为91%，假阴性率为18%。错误分类主要是由于在患有角膜弓的个体中测量瞳孔大小存在困难，导致了大多数假阳性结果，以及其他个体差异。这表明MPSES，包括对环境光照条件的监测，能够在50 - 500勒克斯范围内有效检测阿片类药物的使用情况。我们的研究为使用MPSES检测阿片类药物的使用铺平了道路。
