Quantitative analysis of pupillometry in isolated third nerve palsy - Fig 1

Pupillometry of representative patients in each group at initial (left) and follow-up examinations (right) (A: ischemic, B: inflammatory, C-D: compressive groups). (A) Presumed ischemic third nerve palsy showing normal pupillary light responses. (B) Inflammatory third nerve palsy caused by Tolosa-Hunt syndrome with eye pain, headache, dilated pupil, complete ptosis and ophthalmoplegia. Automated pupillometry shows decreased CON, ACV, MCV and ADV at onset. After 1 month with steroid treatment, pupillary light responses had fully recovered. (C) Compressive third nerve palsy due to parasellar meningioma showing decreased constriction of the pupillary light response. Automated pupillometry shows decreased CON, ACV, and MCV. Three months after stereotactic radiotherapy, full recovery of ptosis, ophthalmoplegia, and pupillary responses were observed. (D) Compressive third nerve palsy due to posterior communicating artery aneurysm with absent pupillary light response on automated pupillometry. After 6 months, no improvement of ptosis, ophthalmoplegia and pupillary light responses were found. ACV = Average constriction velocity; ADV = Average dilation velocity; CON = pupillary constriction ratio (%); MCV = Mean constriction velocity.