497: ROLE OF AUTOMATED PUPILLOMETRY IN NEUROLOGIC ASSESSMENT OF POST-ANGIOGRAPHY PATIENTS

Abstract

Introduction: Automated pupillometry (AP) is an objective bedside tool that can be used to detect early global or regional cerebral dysfunction manifested as asymmetric pupillary light response (PLR). Early detection of neurologic changes after diagnostic or interventional neuroradiologic procedure is important to limit neurologic morbidity and initiate appropriate intervention. In this pilot project, we hypothesized that changes in PLR between pre and post angiography will correlate with pathological changes in the brain. Methods: Single-center, prospective cohort of 50 patients undergoing elective or emergent angiography. 200 PLR recordings were assessed using NPi™-300 Pupillometer. Different PLR properties was recorded 30-min pre and post angiography. Fisher exact test and Kruskal-Wallis test was used to evaluate the relationship between continuous variable and univariate analysis to evaluate associations between categorical variables or mean values of specific parameters. A paired t-test was used to evaluate the differences between pre and post angiography PLR. A p-value < 0.05 was considered statistically significant. Results: Comparing pre and post angiography values, no variables showed a statistically significant difference (p< 0.05) except for the constricted pupil diameter in the left eye (LE) (paired t-test, p=0.03). Comparison of PLR in patients with focal mass lesion showed significant difference in constriction velocity, resting pupil diameter, dilation velocity in the LE, and constricted diameter of both LE and right eye (paired t-test, P 0.005, P = 0.002, P = 0.0098 and P = 0.0023 respectively). For patients who established reperfusion, there were no statistically significant differences in PLR. Conclusions: Our study provides preliminary data regarding the role of AP in documenting PLR abnormalities at baseline in patients with focal brain lesion who underwent angiography. Pre and post intervention PLR changes were not found in our study probably due to absence of major post-intervention complications but would need larger study to verify such hypothesis. This suggests that any changes to PLR is not an expected procedural change and should be treated appropriately.