Evidence map›Paper›PMID 40831073›Full record

ArticleEuropean journal of neurology2025

Validation of Monocular Pupillometry in Healthy Controls and Patients With Autonomic Dysfunction: Pupillary Biomarkers for Autonomic Failure.

Laura Sander, Grace Oommen, Conor Brophy, Silver Bohus-Roper, Giacomo Chiaro, Fion Bremner, Valeria Iodice

Abstract readValidation Study
In one paragraph

Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Laura SanderAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.ORCID 0000-0002-9191-4005
Grace OommenAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.
Conor BrophyAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.
Silver Bohus-RoperAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.
Giacomo ChiaroAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.
Fion BremnerDepartment of Neuro-Ophthalmology, The National Hospital for Neurology and Neurosurgery, London, UK.
Valeria IodiceAutonomic Unit, The National Hospital for Neurology and Neurosurgery, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPupillary function is frequently impaired in autonomic disorders, and biomarkers for early diagnosis and disease progression are urgently needed. Pupillometry allows for noninvasive ocular autonomic evaluation. This prospective study technically and clinically validates a handheld monocular pupillometer available for broad application as an autonomic screening tool in autonomic disorders.

methodsA total of 40 controls and 100 patients with autonomic disorders underwent pupillometry using the PLR-4000(NeurOptics). Pupillary parasympathetic and sympathetic function were assessed by responses to a light stimulus and to 0.5% apraclonidine eye drops, respectively. Test-retest assessments and validations against a binocular device were performed.

resultsIn healthy controls, the mean light reflex ratio was 42% ± 5.7% and the median response to apraclonidine was -5.0% (-8.8%-2.8%). Monocular and binocular pupillometers presented similar results. Test-retest experiments showed: median light response difference 3.0% (1.0%-4.8%), median % difference in response to apraclonidine 5.2% (2.2%-10.6%). In patients with neurodegenerative disorders (n = 24), autonomic neuropathies (n = 39), and autonomic ganglionopathies (n = 9), pupillary abnormalities were very prevalent (52%, 45%, and 100%, respectively). All patients with intermittent autonomic disorders had normal pupillomotor function.

conclusionsThe presented device provides accurate, reproducible assessments of pupillary autonomic function in healthy controls and patients with autonomic disorders. With normative data provided, it is an easily accessible, well-tolerated tool to quantitatively assess pupillomotor innervation in a broad clinical setting. Further studies are warranted to explore its potential as a noninvasive biomarker, complementing standard autonomic function tests for early detection, monitoring disease progression, and evaluating treatment response in disorders with autonomic failure.

Indexed as

Autonomic Nervous System DiseasesPupilReflex, PupillaryAdultAgedBiomarkersClonidineFemaleHumansMaleMiddle AgedProspective StudiesYoung AdultapraclonidineBiomarkersClonidineapraclonidineautoimmune autonomic ganglionopathyautonomic dysfunctionneurodegenerative diseasespupillometry

Identifiers

PMID40831073
PMCPMC12365000

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.