ArticleJournal of clinical monitoring and computing2025
Is quantitative pupillometry affected by ambient light? A prospective crossover study.
Article in Journal of clinical monitoring and computing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Comparison of two automated pupillometry indices in patients with acute brain injury: the prospective multicentre LYNX cohort study.Critical care (London, England) · 2026Observational
- How we use the neurological pupil index (NPi).Critical care (London, England) · 2026Article
- Exploring the relative stability of automated infrared pupillometry parameters under sedative and analgesic exposure after cardiac surgery.BMC anesthesiology · 2026Observational
- Editor letter for Sanna Holmskär "Is quantitative pupillometry affected by ambient light? A prospective crossover study. J Clin Monit Comput, 2025".Journal of clinical monitoring and computing · 2026Article
- Quantitative pupillometry and ambient light. Response to letters to the editor.Journal of clinical monitoring and computing · 2025Article
- Standardizing light conditions during ICU pupillometry: a caution from clinical practice.Journal of clinical monitoring and computing · 2025Article
- Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePupillary examination is a central part of the neurological assessment. While quantitative pupillometry (QP) improves reliability, the impact of ambient light, particularly on the Neurological Pupil index (NPi), remains unclear. This study aimed to clarify the effects of ambient light on QP parameters in a critical care setting.
methodsWe performed a prospective crossover study, including 20 adult patients requiring invasive ventilation. Pupillometry was performed during bright condition (BC1), then dark condition (DC), then bright condition again (BC2). In our primary analysis we compared NPi values across conditions (DC1 vs. BC, BC vs. DC2, DC1 vs. DC2). In the secondary analysis, we compared all other QP parameters.
resultsAll QP values except constriction velocity and dilation velocity were non-normal. The median NPi was significantly lower in BC compared to dark conditions DC1 in both eyes. In 25% of participants the NPi decreased by 0.6 or more. Conversely, a significant increase in median NPi of both eyes was observed when switching from bright conditions back to dark (BC vs. DC2). No significant difference was found between the two dark condition measurements (DC1 and DC2). The secondary analysis showed that the differences in NPi were driven by differences in most, but not all, QP parameters included in NPi.
conclusionsWe corroborate previous findings that the level of ambient light affects QP parameters in critically ill patients. This needs to be considered for accurate interpretation of QP parameters. Future studies may explore potential automated light correction methods for wider clinical applicability.
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