Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study

Background/Objectives. The pupil regulates the incoming light to reduce glare and to achieve sufficient depth of field. Few is known on the distribution of pupil size and associated conditions in the general population. Therefore, for the first time in a large population-based study, we assess the d...

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Main Authors: Marian Kiel, Stephanie D. Grabitz, Susanne Hopf, Thomas Koeck, Philipp S. Wild, Irene Schmidtmann, Karl J. Lackner, Thomas Münzel, Manfred E. Beutel, Norbert Pfeiffer, Alexander K. Schuster
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2022/9520512
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author Marian Kiel
Stephanie D. Grabitz
Susanne Hopf
Thomas Koeck
Philipp S. Wild
Irene Schmidtmann
Karl J. Lackner
Thomas Münzel
Manfred E. Beutel
Norbert Pfeiffer
Alexander K. Schuster
author_facet Marian Kiel
Stephanie D. Grabitz
Susanne Hopf
Thomas Koeck
Philipp S. Wild
Irene Schmidtmann
Karl J. Lackner
Thomas Münzel
Manfred E. Beutel
Norbert Pfeiffer
Alexander K. Schuster
author_sort Marian Kiel
collection DOAJ
description Background/Objectives. The pupil regulates the incoming light to reduce glare and to achieve sufficient depth of field. Few is known on the distribution of pupil size and associated conditions in the general population. Therefore, for the first time in a large population-based study, we assess the distribution of physiologic pupil size and identify associated factors. Subjects/Methods. The Gutenberg Health Study (GHS) is a prospective cohort study established at the University Medical Center Mainz, Germany. As part of the 5-year follow-up (2012–2017), 9,559 of 12,432 participants had a valid pupil size measurement. Optical biometry (Lenstar LS900, Haag-Streit, Koeniz, Switzerland) including measurements of physical pupil diameter, central corneal thickness, corneal curvature, anterior chamber depth, and axial length was performed under mesopic light conditions. The associations of ocular geometry, the participants’ demographics, and their history of systemic diseases and medication intake with physical pupil size were assessed using multivariable linear regression models. Results. 18,335 eyes of 9,559 participants aged 40 to 80 years were included in the analysis. Median pupil diameter was 4.19 mm in right eyes and 4.12 mm in left eyes. A smaller pupil was associated with older age, hyperopic refractive error, previous cataract surgery, diabetes, obesity, and ACE inhibitor intake, whereas wider pupil was associated with female gender, arterial hypertension, intake of tricyclic antidepressants, and intake of SNRI and tetracyclic antidepressants. Socioeconomic status and smoking were not associated with pupil size. Conclusion. Individuals of older age, after cataract surgery, under therapy with ACE inhibitors and with diabetes have a smaller pupil. This should be taken into account when planning nonmydriatic fundus photography-based screening programs, for instance, for diabetic retinopathy.
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spelling doaj-art-0c9cd79b88b84832b6576ed2b9affff32025-02-03T01:22:56ZengWileyJournal of Ophthalmology2090-00582022-01-01202210.1155/2022/9520512Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health StudyMarian Kiel0Stephanie D. Grabitz1Susanne Hopf2Thomas Koeck3Philipp S. Wild4Irene Schmidtmann5Karl J. Lackner6Thomas Münzel7Manfred E. Beutel8Norbert Pfeiffer9Alexander K. Schuster10Department of OphthalmologyDepartment of OphthalmologyDepartment of OphthalmologyPreventive Cardiology and Preventive MedicinePreventive Cardiology and Preventive MedicineInstitute for Medical Biostatistics Epidemiology and Informatics (IMBEI)Institute for Clinical Chemistry and Laboratory MedicineGerman Center for Cardiovascular Research (DZHK)Department for Psychosomatic Medicine und PsychotherapyDepartment of OphthalmologyDepartment of OphthalmologyBackground/Objectives. The pupil regulates the incoming light to reduce glare and to achieve sufficient depth of field. Few is known on the distribution of pupil size and associated conditions in the general population. Therefore, for the first time in a large population-based study, we assess the distribution of physiologic pupil size and identify associated factors. Subjects/Methods. The Gutenberg Health Study (GHS) is a prospective cohort study established at the University Medical Center Mainz, Germany. As part of the 5-year follow-up (2012–2017), 9,559 of 12,432 participants had a valid pupil size measurement. Optical biometry (Lenstar LS900, Haag-Streit, Koeniz, Switzerland) including measurements of physical pupil diameter, central corneal thickness, corneal curvature, anterior chamber depth, and axial length was performed under mesopic light conditions. The associations of ocular geometry, the participants’ demographics, and their history of systemic diseases and medication intake with physical pupil size were assessed using multivariable linear regression models. Results. 18,335 eyes of 9,559 participants aged 40 to 80 years were included in the analysis. Median pupil diameter was 4.19 mm in right eyes and 4.12 mm in left eyes. A smaller pupil was associated with older age, hyperopic refractive error, previous cataract surgery, diabetes, obesity, and ACE inhibitor intake, whereas wider pupil was associated with female gender, arterial hypertension, intake of tricyclic antidepressants, and intake of SNRI and tetracyclic antidepressants. Socioeconomic status and smoking were not associated with pupil size. Conclusion. Individuals of older age, after cataract surgery, under therapy with ACE inhibitors and with diabetes have a smaller pupil. This should be taken into account when planning nonmydriatic fundus photography-based screening programs, for instance, for diabetic retinopathy.http://dx.doi.org/10.1155/2022/9520512
spellingShingle Marian Kiel
Stephanie D. Grabitz
Susanne Hopf
Thomas Koeck
Philipp S. Wild
Irene Schmidtmann
Karl J. Lackner
Thomas Münzel
Manfred E. Beutel
Norbert Pfeiffer
Alexander K. Schuster
Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
Journal of Ophthalmology
title Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
title_full Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
title_fullStr Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
title_full_unstemmed Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
title_short Distribution of Pupil Size and Associated Factors: Results from the Population-Based Gutenberg Health Study
title_sort distribution of pupil size and associated factors results from the population based gutenberg health study
url http://dx.doi.org/10.1155/2022/9520512
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