Automated pupillometry may help predict dosing of opioid agonist therapy for opioid use disorder

Boston, MA: In a new study, Crandall E. Peeler and colleagues found that automated pupillometry exhibited a minor but significant change in mean pupil size within 15 minutes after opioid agonist therapy (OAT) dosage and was linked with low withdrawal ratings. The findings of this study were published in the Journal of Addiction Medicine.

The severity of opioid withdrawal is graded using a crude visual assessment of pupil size. Little research has been conducted to investigate the clinical value of more precise automated pupillometry measures. Keeping this in mind, the following research was conducted to see if there is a statistically significant change in pupil size and reactivity, assessed to the hundredth millimeter using automated pupillometry, related with acceptable withdrawal symptom management in a diverse convenience sample of patients on methadone or buprenorphine for OUD. The secondary goal was to see how rapidly this change might be identified after OAT treatment.

During an acute hospitalization, 27 patients were included in this prospective cohort research to receive OAT to treat cravings or withdrawal. Six sets of automated pupillometry measurements were taken at regular intervals before and after OAT delivery. Pre and after OAT Clinical Opiate Withdrawal Scale readings were taken. The primary objectives included pupil size in both dim and bright lighting (mm). Secondary results were pupillary light response latency (s), constriction and dilation velocity (mm/s), and percent constriction (percent).