Abstract
BackgroundAutomated assessment of the pupillary light reflex (PLR) is becoming more mainstream, yet there is much to learn about the correlations between automated PLR metrics and standard practice. This study explores the feasibility and potential value of assessing PLR using quantitative pupillometry (QP) in patients with critical neurologic illness before and after neuroimaging. MethodsPLR assessments using QP were taken within 30 minutes before and 30 minutes after computerized tomography (CT) or magnetic resonance imaging (MRI) on patients in the neuroscience intensive care unit. ResultsFifty patients were enrolled. The neurological pupil index (NPi®) was 3.98 (1.12) in the right eye and 3.96 (1.0) in the left eye before imaging, and 4.13 (1.08) in the right eye and 4.08 (0.93) in the left eye after imaging. Although the before and after difference in the left eye was a statistically significant (p < .01), these differences were not clinically relevant. Roughly 8% of subjects showed improvement in NPi scores from abnormal (<3.0) before imaging, to normal (>3.0) after. ConclusionObtaining QP readings before and after neuroimaging is feasible and safe. Yet, these data suggest it may not be necessary to obtain pre-QP and post-QP readings when the NPi is normal before CT or MRI.
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