Understanding the Relationship Between the Neurologic Pupil Index and Constriction Velocity Values
Understanding the Relationship Between the Neurologic Pupil Index and Constriction Velocity Values
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DOI：
10.1038/s41598-018-25477-7
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发表时间：
2018-05-03
影响因子：
4.6
通讯作者：
Olson, DaiWai M.
中科院分区：
文献类型：
--
作者：
Shoyombo, Ifeoluwa;Aiyagari, Venkatesh;Olson, DaiWai M.
瞳孔光反射(PLR)描述了当光线照射到视网膜并向Edinger-Westphal核发送信号(颅神经II)时的反应，该信号通过颅神经III导致瞳孔收缩。神经性瞳孔指数(TM)(NPI)和瞳孔收缩速度(CV)是两个截然不同的变量，可以使用瞳孔测量仪进行观察和测量。我们在27,462名学生(1,617名受试者)中检查了NPI和CV。NPI值<；3.0和CV<；0.8 mm/秒被认为是异常的。用回归分析来阐明瞳孔大小和重复测量的影响。在NPI正常的情况下，计算异常CV的优势比(反之亦然)，使用GlimMix(SAS)回归分析。在27462个读数中，49.2%的读数显示双眼NPI正常且CV较快，10.8%的读数显示双眼NPI异常且CV较慢；9.1%的读数显示单眼NPI正常且CV较快，而对侧瞳孔的NPI异常且CV较慢。其余30.9%提示一个或两个PLR的NPI正常，但CV慢，或NPI异常，CV快。快CV不排除PLR异常；慢CV不排除PLR异常。从业者在解释瞳孔测量学读数时应该考虑到这些含义。
The pupillary light reflex (PLR) describes the response when light hits the retina and sends a signal (cranial nerve II) to the Edinger-Westphal Nucleus which via cranial nerve III results in pupillary constriction. The Neurological Pupil index (TM) (NPi) and pupil constriction velocity (CV) are two distinct variables that can be observed and measured using a pupillometer. We examine NPi and CV in 27,462 pupil readings (1,617 subjects). NPi values < 3.0 and a CV < 0.8 mm/sec were considered abnormal. Regression was used to clarify the effect of pupil size and repeated measures. An odds ratio of abnormal CV given normal NPi (and vice versa) was computed using the glimmixed (SAS) regression. Of 27,462 readings, 49.2% revealed bilaterally normal NPi wtih brisk CV, and 10.8% revealed bilaterally abnormal NPi and slow CV; 9.1% with unilaterally normal NPi and brisk CV where the opposite pupil had an abnormal NPi and slow CV. The remaining 30.9% revealed that one or both PLR had either a normal NPi with slow CV, or abnormal NPi with brisk CV. Brisk CV does not rule out an abnormal PLR; slow CV does not rule in abnormal PLR. Practitioners should consider these implications when interpreting pupillometry readings.