Physiologic anisocoria under various lighting conditions

Ryan P Steck,1 Min Kong,2 Kaydee L McCray,3 Valerie Quan,3 Pinakin Gunvant Davey3 1Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA, USA; 2Visual Science and Optometry Center, The People’s Hospital of Guangxi Nanning, Zhuang Autonomous Regi...

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Autores principales:	Steck RP, Kong M, McCray KL, Quan V, Davey PG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	anisocoria pupillometry pupil diameter Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2bdc6532b7f14f77b0715fb45471a7c3
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spelling	oai:doaj.org-article:2bdc6532b7f14f77b0715fb45471a7c32021-12-02T01:51:07ZPhysiologic anisocoria under various lighting conditions1177-5483https://doaj.org/article/2bdc6532b7f14f77b0715fb45471a7c32018-01-01T00:00:00Zhttps://www.dovepress.com/physiologic-anisocoria-under-various-lighting-conditions-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ryan P Steck,1 Min Kong,2 Kaydee L McCray,3 Valerie Quan,3 Pinakin Gunvant Davey3 1Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA, USA; 2Visual Science and Optometry Center, The People’s Hospital of Guangxi Nanning, Zhuang Autonomous Region, China; 3Western University of Health Sciences, College of Optometry, Pomona, CA, USA Purpose: To evaluate the measurement of anisocoria in a group of ocular healthy subjects using a standardized protocol in scotopic, mesopic, and photopic lighting conditions, and determine the optimal threshold of difference in pupil diameter in determining physiologic anisocoria.Methods: Right and left pupil diameters of 126 ocular healthy subjects with a mean age 30.5±7.8 years (40 males and 86 females) were measured sequentially under photopic conditions using a monocular infrared pupillometer. A sub-group of 51 individuals had right and left pupil measurements performed under three additional lighting conditions, allowing for a 2-minute recovery between measurements. A white light emitting diode (LED) in the eyecup of the pupillometer produced three controlled light settings: scotopic (0 lux), low mesopic (0.3 lux), and high mesopic (3 lux). The criterion for anisocoria was defined as ≥0.4 mm difference in pupil diameter between the eyes.Results: In the 126 subjects tested, 23.8% (n=30) exhibited anisocoria in photopic conditions. In the sub-group measured under three additional light settings, 43.1% (n=22) exhibited anisocoria in scotopic conditions, 43.1% (n=22) in low mesopic conditions, and 47.1% (n=24) in high mesopic conditions. Approximately 73% of subjects exhibited anisocoria in at least one light setting, while only approximately 8% had anisocoria in every light setting. When the criterion for anisocoria was shifted to ≥0.2 mm or ≥0.6 mm, the prevalence of anisocoria shifted significantly. Using a higher cutoff of ≥0.6 mm effectively reduced the number of healthy individuals who exhibit anisocoria in every light setting to almost zero.Conclusion: Based on our data, anisocoria is more prevalent under varied lighting conditions. To ensure the anisocoria is due to physiologic reasons, one should ensure that it is present under all lighting conditions to avoid excessive false positives. Keywords: anisocoria, pupillometry, pupil diameterSteck RPKong MMcCray KLQuan VDavey PGDove Medical Pressarticleanisocoriapupillometrypupil diameterOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 85-89 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	anisocoria pupillometry pupil diameter Ophthalmology RE1-994
spellingShingle	anisocoria pupillometry pupil diameter Ophthalmology RE1-994 Steck RP Kong M McCray KL Quan V Davey PG Physiologic anisocoria under various lighting conditions
description	Ryan P Steck,1 Min Kong,2 Kaydee L McCray,3 Valerie Quan,3 Pinakin Gunvant Davey3 1Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA, USA; 2Visual Science and Optometry Center, The People’s Hospital of Guangxi Nanning, Zhuang Autonomous Region, China; 3Western University of Health Sciences, College of Optometry, Pomona, CA, USA Purpose: To evaluate the measurement of anisocoria in a group of ocular healthy subjects using a standardized protocol in scotopic, mesopic, and photopic lighting conditions, and determine the optimal threshold of difference in pupil diameter in determining physiologic anisocoria.Methods: Right and left pupil diameters of 126 ocular healthy subjects with a mean age 30.5±7.8 years (40 males and 86 females) were measured sequentially under photopic conditions using a monocular infrared pupillometer. A sub-group of 51 individuals had right and left pupil measurements performed under three additional lighting conditions, allowing for a 2-minute recovery between measurements. A white light emitting diode (LED) in the eyecup of the pupillometer produced three controlled light settings: scotopic (0 lux), low mesopic (0.3 lux), and high mesopic (3 lux). The criterion for anisocoria was defined as ≥0.4 mm difference in pupil diameter between the eyes.Results: In the 126 subjects tested, 23.8% (n=30) exhibited anisocoria in photopic conditions. In the sub-group measured under three additional light settings, 43.1% (n=22) exhibited anisocoria in scotopic conditions, 43.1% (n=22) in low mesopic conditions, and 47.1% (n=24) in high mesopic conditions. Approximately 73% of subjects exhibited anisocoria in at least one light setting, while only approximately 8% had anisocoria in every light setting. When the criterion for anisocoria was shifted to ≥0.2 mm or ≥0.6 mm, the prevalence of anisocoria shifted significantly. Using a higher cutoff of ≥0.6 mm effectively reduced the number of healthy individuals who exhibit anisocoria in every light setting to almost zero.Conclusion: Based on our data, anisocoria is more prevalent under varied lighting conditions. To ensure the anisocoria is due to physiologic reasons, one should ensure that it is present under all lighting conditions to avoid excessive false positives. Keywords: anisocoria, pupillometry, pupil diameter
format	article
author	Steck RP Kong M McCray KL Quan V Davey PG
author_facet	Steck RP Kong M McCray KL Quan V Davey PG
author_sort	Steck RP
title	Physiologic anisocoria under various lighting conditions
title_short	Physiologic anisocoria under various lighting conditions
title_full	Physiologic anisocoria under various lighting conditions
title_fullStr	Physiologic anisocoria under various lighting conditions
title_full_unstemmed	Physiologic anisocoria under various lighting conditions
title_sort	physiologic anisocoria under various lighting conditions
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/2bdc6532b7f14f77b0715fb45471a7c3
work_keys_str_mv	AT steckrp physiologicanisocoriaundervariouslightingconditions AT kongm physiologicanisocoriaundervariouslightingconditions AT mccraykl physiologicanisocoriaundervariouslightingconditions AT quanv physiologicanisocoriaundervariouslightingconditions AT daveypg physiologicanisocoriaundervariouslightingconditions
_version_	1718402823595491328

Physiologic anisocoria under various lighting conditions

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