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목적 : PURPOSE: To evaluate the efficacy of digital pupillometry in the diagnosis of anisocoria related to Horner syndrome in adult patients.
방법 : Nineteen patients with Horner syndrome (Horner group) and 30 healthy controls were included. METHODS: Pupillary light reflex (PLR) of the Horner group and controls were measured by a dynamic pupillometer. Pupil diameter, latency, constriction ratio, constriction velocity, dilation velocity, and total time taken by the pupil to recover 75% of maximum (T75) were noted. PLR were measured at baseline and at 30-45 minutes later after 0.5% apraclonidine instillation. The inter-eye difference in PLR parameters before and after 0.5% apraclonidine instillation was evaluated.
결과 : RESULTS: In the Horner group, pupil diameter, constriction ratio, average dilation velocity, and T75 showed significant difference between the affected eye and unaffected eye at baseline (all P<0.05). Compared to controls, inter-eye difference values of pupil diameter and T75 were significantly larger in the Horner group (all P<0.001). After 0.5% apraclonidine instillation, changes of pupil diameter, latency, constriction ratio and velocity were significantly larger in the affected eye compared to the unaffected eye (all P<0.05).
결론 : The area under the receiver operating characteristic curves for diagnosing Horner syndrome were largest for the baseline T75 and baseline inter-eye difference of maximal and minimal pupil diameter (AUC = 0.824, 975, and 994, respectively).
CONCLUSION: Digital pupillometry quantifies the PLR and provides valuable and detailed information of pupil response in patients with Horner syndrome. Digital pupillometry should be considered a candidate to replace pupil photo in the diagnosis of Horner syndrome.
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