The Pupillary Light Reflex in Idiopathic Intracranial Hypertension.

Jan 10, 2016Investigative ophthalmology & visual science

How the Pupils Respond to Light in People with Unknown-Cause Brain Pressure Increase

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Abstract

IIH patients exhibited significantly smaller pupillary light reflex responses under both melanopsin and rod conditions.

  • Pupillary light reflexes were smaller in IIH patients compared to normal controls for melanopsin (P < 0.001) and rod (P = 0.04) conditions.
  • A trend towards reduced cone-mediated pupillary light reflexes was observed (P = 0.08).
  • Receiver operating characteristic analysis showed areas under the curves of 0.83 for melanopsin, 0.71 for rod, and 0.77 for cone conditions.
  • The combined analysis of rod, cone, and melanopsin responses yielded a high area under the curve of 0.90, with sensitivity and specificity both at 85%.
  • Reductions in pupillary light reflexes suggest compromised retinal ganglion cell function in IIH patients.

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