Pupillary light reflex metrics may serve as biomarker for concussion

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Quantitative metrics of the pupillary light reflex are greater in adolescents with adolescent sport-related concussions and may act as a physiological biomarker for concussion, according to a study in JAMA Ophthalmology.

In this prospective cohort, the pupillary light reflex metrics of 134 healthy control individuals and 98 athletes with a diagnosis of sport-related concussion were obtained an average of 12 days after the injury occurred.  

Metrics including, maximum and minimum pupillary diameter, percentage constriction, peak and average constriction velocity, peak and average dilation velocity, and time to 75% pupillary redilation, were significantly greater among athletes with concussion after Bonferroni correction.

An exploratory analysis found that females with concussions had longer T75 (1.96 seconds vs 1.63 seconds)

Researchers also noted that healthy athletes had diminished PLR metrics after exercise.

Master CL, Podolak OE, Ciuffreda KJ, et al. Utility of Pupillary Light Reflex Metrics as a Physiologic Biomarker for Adolescent Sport-Related Concussion. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2020.3466

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