Quantitative Pupillometry Values are Remarkably Similar Before and After Neuroimaging

Dai Wai M. Olson; Sonja E. Stutzman; Emerson B. Nairon; Ranier Reyes

doi:10.1016/j.jradnu.2023.03.001

Quantitative Pupillometry Values are Remarkably Similar Before and After Neuroimaging

Dai Wai M. Olson, Sonja E. Stutzman, Emerson B. Nairon, Ranier Reyes

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Automated 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. Methods: PLR 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. Results: Fifty 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. Conclusion: Obtaining 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.

Original language	English (US)
Pages (from-to)	305-309
Number of pages	5
Journal	Journal of Radiology Nursing
Volume	42
Issue number	3
DOIs	https://doi.org/10.1016/j.jradnu.2023.03.001
State	Published - Sep 2023

Keywords

Cranial nerves
Intensive care unit
Neuroimaging
Pupil

ASJC Scopus subject areas

Radiological and Ultrasound Technology
Advanced and Specialized Nursing

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10.1016/j.jradnu.2023.03.001

Cite this

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title = "Quantitative Pupillometry Values are Remarkably Similar Before and After Neuroimaging",

abstract = "Background: Automated 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. Methods: PLR 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. Results: Fifty patients were enrolled. The neurological pupil index (NPi{\textregistered}) 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. Conclusion: Obtaining 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.",

keywords = "Cranial nerves, Intensive care unit, Neuroimaging, Pupil",

author = "Olson, {Dai Wai M.} and Stutzman, {Sonja E.} and Nairon, {Emerson B.} and Ranier Reyes",

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year = "2023",

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language = "English (US)",

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AU - Stutzman, Sonja E.

AU - Nairon, Emerson B.

AU - Reyes, Ranier

PY - 2023/9

Y1 - 2023/9

N2 - Background: Automated 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. Methods: PLR 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. Results: Fifty 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. Conclusion: Obtaining 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.

AB - Background: Automated 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. Methods: PLR 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. Results: Fifty 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. Conclusion: Obtaining 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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Quantitative Pupillometry Values are Remarkably Similar Before and After Neuroimaging

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