DESCRIBING ANISOCORIA IN NEUROCRITICALLY ILL PATIENTS

Saju C, Barnes A, Kuramatsu J, Marshall JL, Obinata H, Puccio AM, Yokobori S, Olson DM (2023)

Publication Type: Journal article

Publication year: 2023

Journal

American Journal of Critical Care American Association of Critical Care Nurses

Book Volume: 32

Pages Range: 402-409

Journal Issue: 6

DOI: 10.4037/ajcc2023558

Abstract

Background Anisocoria (unequal pupil size) has been defined using cut points ranging from greater than 0.3 mm to greater than 2.0 mm for absolute difference in pupil size. This study explored different pupil diameter cut points for assessing anisocoria as measured by quantitative pupillometry before and after light stimulus. Methods An exploratory descriptive study of international registry data was performed. The first observations in patients with paired left and right quantitative pupillometry measurements were included. Measurements of pupil size before and after stimulus with a fixed light source were used to calculate anisocoria. Results The sample included 5769 patients (mean [SD] age, 57.5 [17.6] years; female sex, 2558 patients [51.5%]; White race, 3669 patients [75.5%]). Anisocoria defined as pupil size difference of greater than 0.5 mm was present in 1624 patients (28.2%) before light stimulus; 645 of these patients (39.7%) also had anisocoria after light stimulus (P <.001). Anisocoria defined as pupil size difference of greater than 2.0 mm was present in 79 patients (1.4%) before light stimulus; 42 of these patients (53.2%) also had anisocoria after light stimulus (P <.001). Discussion The finding of anisocoria significantly differed before and after light stimulus and according to the cut point used. At most cut points, fewer than half of the patients who had anisocoria before light stimulus also had anisocoria after light stimulus. Conclusion The profound difference in the number of patients adjudicated as having anisocoria using different cut points reinforces the need to develop a universal definition for anisocoria.

Authors with CRIS profile

Joji Kuramatsu Medizinische Fakultät

Involved external institutions

University of Texas Southwestern Medical Center (UT Southwestern) US United States (USA) (US) Barnes-Jewish Hospital US United States (USA) (US) Nippon Medical School JP Japan (JP) University of Pittsburgh US United States (USA) (US)

How to cite

APA:

Saju, C., Barnes, A., Kuramatsu, J., Marshall, J.L., Obinata, H., Puccio, A.M.,... Olson, D.M. (2023). DESCRIBING ANISOCORIA IN NEUROCRITICALLY ILL PATIENTS. American Journal of Critical Care, 32(6), 402-409. https://doi.org/10.4037/ajcc2023558

MLA:

Saju, Ciji, et al. "DESCRIBING ANISOCORIA IN NEUROCRITICALLY ILL PATIENTS." American Journal of Critical Care 32.6 (2023): 402-409.

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