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

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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