Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite
Objectives The purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metric...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/2/e080779.full |
| _version_ | 1797271643390738432 |
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| author | DaiWai M Olson Brian Nguyen Jade L Marshall Chahat Rana Folefac D Atem Sonja E Stutzman Venkatesh Aiyagari Bappaditya Ray |
| author_facet | DaiWai M Olson Brian Nguyen Jade L Marshall Chahat Rana Folefac D Atem Sonja E Stutzman Venkatesh Aiyagari Bappaditya Ray |
| author_sort | DaiWai M Olson |
| collection | DOAJ |
| description | Objectives The purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metrics.Design This was a prospective, observational pilot study of PLR assessments obtained using QP 30 min before and after DCA. All patients had QP measurements performed with the NPi-300 (Neuroptics) pupillometer.Setting Recruitment was done at a single-centre, tertiary-care academic hospital and comprehensive stroke centre in Dallas, Texas.Participants Fifty participants were recruited undergoing elective or emergent angiography. Inclusion criteria were a physician-ordered interventional neuroradiological procedure, at least 18 years of age, no contraindications to PLR assessment with QP, and nursing transport to and from DCA. Patients with a history of eye surgery were excluded.Main outcome measures Difference in PLR metric obtained from QP 30 min before and after DCA.Results Statistically significant difference was noted in the pre and post left eye readings for the minimum pupil size (a.k.a., pupil diameter on maximum constriction). The mean maximum constriction diameter prior to angiogram of 3.2 (1.1) mm was statistically larger than after angiogram (2.9 (1.0) mm; p<0.05); however, this was not considered clinically significant. Comparisons for all other PLR metrics pre and post angiogram demonstrated no significant difference. Using change in NPi pre and post angiogram (Δpre=0.05 (0.77) vs Δpost=0.08 (0.67); p=0.62), we calculated the effect size as 0.042. Hence, detecting a statistically significant difference in NPi, if a difference exists, would require a sample size of ~6000 patients.Conclusions Our study provides supportive data that in an uncomplicated angiogram, even with intervention, there is no effect on the PLR. |
| first_indexed | 2024-03-07T14:08:26Z |
| format | Article |
| id | doaj.art-0cab70259f3048cbaacf4132fe4ae139 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-07T14:08:26Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-0cab70259f3048cbaacf4132fe4ae1392024-03-06T18:15:09ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-080779Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suiteDaiWai M Olson0Brian Nguyen1Jade L Marshall2Chahat Rana3Folefac D Atem4Sonja E Stutzman5Venkatesh Aiyagari6Bappaditya Ray7Neurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USANeurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USANeurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USABiostatistics, University of Texas Southwestern Medical Center, Dallas, Texas, USABiostatistics, University of Texas Southwestern Medical Center, Dallas, Texas, USANeurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USANeurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USANeurology - Division of Neurocritical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USAObjectives The purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metrics.Design This was a prospective, observational pilot study of PLR assessments obtained using QP 30 min before and after DCA. All patients had QP measurements performed with the NPi-300 (Neuroptics) pupillometer.Setting Recruitment was done at a single-centre, tertiary-care academic hospital and comprehensive stroke centre in Dallas, Texas.Participants Fifty participants were recruited undergoing elective or emergent angiography. Inclusion criteria were a physician-ordered interventional neuroradiological procedure, at least 18 years of age, no contraindications to PLR assessment with QP, and nursing transport to and from DCA. Patients with a history of eye surgery were excluded.Main outcome measures Difference in PLR metric obtained from QP 30 min before and after DCA.Results Statistically significant difference was noted in the pre and post left eye readings for the minimum pupil size (a.k.a., pupil diameter on maximum constriction). The mean maximum constriction diameter prior to angiogram of 3.2 (1.1) mm was statistically larger than after angiogram (2.9 (1.0) mm; p<0.05); however, this was not considered clinically significant. Comparisons for all other PLR metrics pre and post angiogram demonstrated no significant difference. Using change in NPi pre and post angiogram (Δpre=0.05 (0.77) vs Δpost=0.08 (0.67); p=0.62), we calculated the effect size as 0.042. Hence, detecting a statistically significant difference in NPi, if a difference exists, would require a sample size of ~6000 patients.Conclusions Our study provides supportive data that in an uncomplicated angiogram, even with intervention, there is no effect on the PLR.https://bmjopen.bmj.com/content/14/2/e080779.full |
| spellingShingle | DaiWai M Olson Brian Nguyen Jade L Marshall Chahat Rana Folefac D Atem Sonja E Stutzman Venkatesh Aiyagari Bappaditya Ray Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite BMJ Open |
| title | Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| title_full | Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| title_fullStr | Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| title_full_unstemmed | Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| title_short | Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| title_sort | prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite |
| url | https://bmjopen.bmj.com/content/14/2/e080779.full |
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