Evaluation of static and dynamic pupil responses in patients with acromegaly with automatic pupillometer.

backgroundAcromegaly is a chronic disorder caused by excessive secretion of growth hormone and IGF-I, usually from a benign pituitary adenoma, leading to systemic complications and increased mortality. Abnormal pupillary responses may indicate neurological or ophthalmic dysfunction. This study investigates pupillary response alterations in acromegaly patients using automatic pupillometry.

methodsThis prospective cross-sectional study involved 50 individuals diagnosed with acromegaly and an equal number of age- and sex-matched healthy controls. All subjects underwent a complete ophthalmological examination. Pupillary measurements were obtained static conditions (scotopic, mesopic and low-high photopic) and dynamic (rest pupil diameter, contraction amplitude, latency, contraction duration, contraction velocity, dilation latency, resting duration and velocity) using an automatic pupillometer.

resultsThe mean age of the patients with acromegaly was similar to that of the healthy control group (44.80 ± 4.46 and 42.52 ± 4.40 years, p = 0.85). According to the results of our study, mesopic and low- and high-photopic pupil diameter (PD) were significantly lower in patients with acromegaly (p = 0.003, p < 0.001, and p < 0.001, respectively). In addition, when the dynamic pupillometry parameters of these patients were examined, it was found that the resting diameter, contraction amplitude, duration, and velocity (p < 0.001, all values), and dilatation latency and velocity were significantly lower (p < 0.001, both values), while only the latency of pupil contraction was higher (p = 0.02).The mean age of patients with acromegaly was comparable to that of the healthy control group (44.80 ± 4.46 vs. 42.52 ± 4.40 years, p = 0.85). Analysis revealed that pupil PD under mesopic, low photopic, and high photopic conditions were significantly reduced in the acromegaly cohort (p = 0.003, p < 0.001, and p < 0.001, respectively). Furthermore, evaluation of dynamic pupillometry parameters demonstrated that resting pupil diameter, contraction amplitude, contraction duration, and contraction velocity were all significantly decreased (p < 0.001 for each). Similarly, both dilatation latency and dilatation velocity were markedly diminished (p < 0.001 for both), whereas the latency of pupil contraction was significantly prolonged (p = 0.02).

conclusionsOur findings indicate that both static and dynamic pupillometry parameters are compromised in patients with acromegaly. Consequently, the use of an automatic pupillometry system in these patients may serve as a convenient, non-invasive screening method for assessing pupil function. Nonetheless, a more comprehensive understanding of these effects necessitates multicenter studies with larger sample sizes and longer durations.