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Purpose <p>To evaluate the association between dynamic pupillometry parameters and in vivo confocal microscopy (IVCM)-derived corneal sub-basal nerve morphology in patients with immune-related dry eye disease.</p> Methods <p>A cross-sectional study was conducted on 28 patients with immune-related dry eye disease (DED). Corneal sub-basal nerve morphology, including corneal nerve fiber length density (CNFL), intensity, and tortuosity, was quantified using IVCM. Dynamic pupillary light reflexes, including pupil size diameter and constriction/dilation velocities, were measured via automated pupillometry. Correlation and multivariate regression analysis were employed to determine the independent associations between structural nerve metrics and functional pupillary parameters.</p> Results <p>Significant positive correlations were observed between CNFL and baseline pupil size, recovery pupil size, and total contraction and dilation time. Multivariate regression confirmed that CNFL remained an independent predictor of baseline pupil diameter after adjusting for age and gender.</p> Conclusion <p>Structural rarefaction of the corneal sub-basal nerves is closely mirrored by functional impairments in pupillary dynamics. Dynamic pupillometry may provide complementary functional information associated with corneal nerve alterations in patients with immune-related DED.</p>

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Association between dynamic pupil parameters and corneal sub-basal nerve plexus morphology

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Wenyan Zhou,
  • Zhiyu Zhang,
  • Haozhe Yu,
  • Jingyi Li,
  • Renxu Li,
  • Zhongqiang Yao,
  • Xiaojun He,
  • Yun Feng

摘要

Purpose

To evaluate the association between dynamic pupillometry parameters and in vivo confocal microscopy (IVCM)-derived corneal sub-basal nerve morphology in patients with immune-related dry eye disease.

Methods

A cross-sectional study was conducted on 28 patients with immune-related dry eye disease (DED). Corneal sub-basal nerve morphology, including corneal nerve fiber length density (CNFL), intensity, and tortuosity, was quantified using IVCM. Dynamic pupillary light reflexes, including pupil size diameter and constriction/dilation velocities, were measured via automated pupillometry. Correlation and multivariate regression analysis were employed to determine the independent associations between structural nerve metrics and functional pupillary parameters.

Results

Significant positive correlations were observed between CNFL and baseline pupil size, recovery pupil size, and total contraction and dilation time. Multivariate regression confirmed that CNFL remained an independent predictor of baseline pupil diameter after adjusting for age and gender.

Conclusion

Structural rarefaction of the corneal sub-basal nerves is closely mirrored by functional impairments in pupillary dynamics. Dynamic pupillometry may provide complementary functional information associated with corneal nerve alterations in patients with immune-related DED.