Park Jason C, McAnany J Jason
University of Illinois Chicago.
Res Sq. 2025 Sep 19:rs.3.rs-7383219. doi: 10.21203/rs.3.rs-7383219/v1.
Pupillometry is most commonly performed in laboratory settings using specialized, non-portable instruments that require lengthy test protocols. The purpose of this study was to develop and evaluate a rapid, clinically-applicable pupillometry protocol using a commercially available, portable, handheld instrument.
Thirty-seven healthy individuals (ages 21- 61 years) participated in three experiments. In each experiment, the pupillary light reflex (PLR) was elicited by full-field, 500-ms chromatic flashes (470 nm and 621 nm; 12,000 Td). Experiment I evaluated the minimum dark adaptation (DA) time needed to achieve maximum PLRs. Experiment II determined the effect of age. Experiment III estimated PLR test-retest repeatability. For all experiments, baseline pupil size (BL; 1 sec before flash onset), maximum pupil constriction (MPC) following the flash, and post-illumination pupillary response (PIPR; median size 6 - 8 sec after flash offset) were quantified.
Experiment I showed that from 1 - 3 min of DA, BL and MPC increased slightly (0.27 mm and 5%, respectively), whereas the PIPR increased considerably (17%). The responses did not change appreciably after 3 min, therefore a 3-min DA period was used for Experiments II and III. Experiment II showed a trend for BL and MPC to decrease with age, but correlations with age were not statistically significant (all p > 0.05). PIPR was independent of age (r = -0.01; p = 0.96). Experiment III showed test-retest repeatability of approximately 1 mm for BL, and 10% for MPC and PIPR, indicating good repeatability.
The proposed approach is useful for measuring the MPC and PIPR across a broad range of ages and baseline pupil sizes. Given the device portability and short test duration (approximately 5 minutes including DA), this approach has promising clinical utility.
瞳孔测量通常在实验室环境中使用专门的、非便携式仪器进行，这些仪器需要冗长的测试方案。本研究的目的是使用市售的便携式手持仪器开发并评估一种快速、临床适用的瞳孔测量方案。
37名健康个体（年龄21 - 61岁）参与了三项实验。在每个实验中，通过全视野、500毫秒的彩色闪光（470纳米和621纳米；12,000特罗兰）诱发瞳孔光反射（PLR）。实验I评估了实现最大PLR所需的最短暗适应（DA）时间。实验II确定了年龄的影响。实验III估计了PLR的重测重复性。对于所有实验，量化了基线瞳孔大小（BL；闪光开始前1秒）、闪光后最大瞳孔收缩（MPC）以及闪光停止后6 - 8秒的照明后瞳孔反应（PIPR；中位大小）。
实验I表明，从DA 1 - 3分钟，BL和MPC略有增加（分别为0.27毫米和5%），而PIPR显著增加（17%）。3分钟后反应没有明显变化，因此实验II和III使用3分钟的DA期。实验II显示BL和MPC有随年龄下降的趋势，但与年龄的相关性无统计学意义（所有p>0.05）。PIPR与年龄无关（r = -0.01；p = 0.96）。实验III显示BL的重测重复性约为1毫米，MPC和PIPR的重测重复性为10%，表明重复性良好。
所提出的方法可用于测量广泛年龄范围和基线瞳孔大小的MPC和PIPR。鉴于设备的便携性和较短的测试持续时间（包括DA约5分钟），该方法具有良好的临床应用前景。
