Journal of Pediatric Ophthalmology & Strabismus, 2015;52(3):147–151
Abstract
Purpose:
The goal of this study was to establish normative values for measurements of quantitative pupillometry in children.
Methods:
Quantitative pupillometry measurements were obtained from children between 1 and 18 years of age being seen for either a well child check or other outpatient appointment.
Results:
Maximum and minimum pupil size increased slightly with age; however, the correlation was weak (r = 0.29 and 0.19, respectively). Similarly weak correlations with age also were observed for maximum constriction velocity (r = −0.29) and dilation velocity (r = 0.27). Maximum (5.56 vs 4.97 mm) and minimum (3.74 vs 3.40 mm) pupil sizes were significantly larger in whites than in African Americans.
Conclusions:
Pupil size and reactivity show little correlation with age and are therefore suitable for further exploration in using pupillometry as a biomarker across the pediatric age range. Differences in race should be taken into consideration when pupillometry is used in mixed populations.
[J Pediatr Ophthalmol Strabismus. 2015:52(3):147–151.]
- 1.Chamoun RB, Robertson CS, Gopinath SP. Outcome in patients with blunt head trauma and Glasgow Coma Scale score of 3 at presentation. J Neurosurg. 2009; 111:683–687.
10.3171/2009.2.JNS08817 Crossref MedlineGoogle Scholar - 2.Benziger DP, Miotto J, Grandy RP, Thomas GB, Swanton RE, Fitzmartin RD. A pharmacokinetic/pharmacodynamic study of controlled-release oxycodone. J Pain Symptom Manage. 1997; 13:75–82.
10.1016/S0885-3924(96)00300-4 Crossref MedlineGoogle Scholar - 3.Cury MR, Martinez FE, Carlotti AP. Pain assessment in neonates and infants in the post-operative period following cardiac surgery. Postgrad Med J. 2013; 89:63–67.
10.1136/postgradmedj-2012-130808 Crossref MedlineGoogle Scholar - 4.Ibrahim AE, Feldman J, Karim A, Kharasch ED. Simultaneous assessment of drug interactions with low- and high-extraction opioids: application to parecoxib effects on the pharmacokinetics and pharmacodynamics of fentanyl and alfentanil. Anesthesiology. 2003; 98:853–61.
10.1097/00000542-200304000-00011 Crossref MedlineGoogle Scholar - 5.Macleod DB, Habib AS, Ikeda K, Inhaled fentanyl aerosol in healthy volunteers: pharmacokinetics and pharmacodynamics. Anesth Analg. 2012; 115:1071–1077.
10.1213/ANE.0b013e3182691898 Crossref MedlineGoogle Scholar - 6.Matouskova O, Slanar O, Chytil L, Pupillometry in healthy volunteers as a biomarker of tramadol efficacy. J Clin Pharmacol Ther. 2011; 36:513–517.
10.1111/j.1365-2710.2010.01203.x Crossref MedlineGoogle Scholar - 7.Phimmasone S, Kharasch ED. A pilot evaluation of alfentanil-induced miosis as a noninvasive probe for hepatic cytochrome P450 3A4 (CYP3A4) activity in humans. Clin Pharmacol Ther. 2001; 70:505–517.
10.1067/mcp.2001.119994 Crossref MedlineGoogle Scholar - 8.Meeker M, Du R, Bacchetti P, Pupil examination: validity and clinical utility of an automated pupillometer. J Neurosci Nurs. 2005; 37:34–40.
10.1097/01376517-200502000-00006 Crossref MedlineGoogle Scholar - 9.Aissou M, Snauwaert A, Dupuis C, Atchabahian A, Aubrun F, Beaussier M. Objective assessment of the immediate postoperative analgesia using pupillary reflex measurement: a prospective and observational study. Anesthesiology. 2012; 116:1006–1012.
10.1097/ALN.0b013e318251d1fb Crossref MedlineGoogle Scholar - 10.Barvais L, Engelman E, Eba JM, Coussaert E, Cantraine F, Kenny GN. Effect site concentrations of remifentanil and pupil response to noxious stimulation. Br J Anaesth. 2003; 91:347–352.
10.1093/bja/aeg178 Crossref MedlineGoogle Scholar - 11.Constant I, Nghe MC, Boudet L, Reflex pupillary dilatation in response to skin incision and alfentanil in children anaesthetized with sevoflurane: a more sensitive measure of noxious stimulation than the commonly used variables. Br J Anaesth. 2006; 96:614–619.
10.1093/bja/ael073 Crossref MedlineGoogle Scholar - 12.Neville K, Connelly M. Pupillometry: a pharmacodynamic tool to measure opioid analgesia in pediatrics. Clin Pharmacol Ther. 2010; 87:S65–S66. MedlineGoogle Scholar
- 13.Boev AN, Fountas KN, Karampelas I, Quantitative pupillometry: normative data in healthy pediatric volunteers. J Neurosurg. 2005; 103(6 suppl pediatrics):496–500. MedlineGoogle Scholar
- 14.Kohnen EM, Zubcov AA, Kohnen T. Scotopic pupil size in a normal pediatric population using infrared pupillometry. Graefes Arch Clin Exp Ophthalmol. 2004; 242:18–23.
10.1007/s00417-003-0735-4 Crossref MedlineGoogle Scholar - 15.Machlachlan M, Howland H. Normal values and standard deviations for pupil diameter and interpupillary distance in subjects aged 1 month to 19 years. Ophthal Physiol Opt. 2002; 22:175–182.
10.1046/j.1475-1313.2002.00023.x Crossref MedlineGoogle Scholar - 16.Taylor WR, Chen JW, Meltzer H, Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury. J Neurosurg. 2003; 98:205–213.
10.3171/jns.2003.98.1.0205 Crossref MedlineGoogle Scholar - 17.Eustis HS, Guthrie ME. Normal development: postnatal development. In: , eds. Pediatric Ophthalmology and Strabismus. New York: Oxford UP; 2012:60–61. Google Scholar
