Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector70130010.17816/medjrf701300KVIUFEReviewsНаучные обзорыReview ArticlePupillometry as an interdisciplinary tool in ophthalmological and neurological diagnostics: a reviewВозможности пупиллометрии как междисциплинарного инструмента в офтальмологической и неврологической диагностике: обзорhttps://orcid.org/0000-0003-3956-63623223-6006SuponevaNatalia A.СупоневаНаталья Александровна
Russian Federation

д-р мед. наук, профессор, член-корреспондент РАН

suponeva@neurology.ruhttps://orcid.org/0000-0002-9833-62361697-6960FrolovMikhail A.ФроловМихаил Александрович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

frolov_ma@pfur.ruhttps://orcid.org/0000-0003-2707-84171693-3019VorobyevaIrina V.ВоробьеваИрина Витальевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

vorobyeva_iv@pfur.ruhttps://orcid.org/0000-0003-0988-13616338-9946FrolovAleksandr M.ФроловАлександр Михайлович
Russian Federation

MD, Cand. Sci. (Medicine), Associate Professor

канд. мед. наук, доцент

frolov_am@pfur.ruhttps://orcid.org/0000-0002-9130-12928282-3920SergeevDmitry V.СергеевДмитрий Владимирович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

sergeev@neurology.ruhttps://orcid.org/0009-0003-6567-87791722-2917SeminaDaria A.СеминаДарья Андреевна
Russian Federation

MD

semina.dariaan@yandex.ruhttps://orcid.org/0009-0004-5980-7789BudazhapovAyur L.БудажаповАюр Лубсанович
Russian Federation

MD

1152240351@pfur.ruhttps://orcid.org/0009-0003-5897-7594NovikovDanil K.НовиковДанил Константинович
Russian Federation

MD

danil61503@gmail.comhttps://orcid.org/0000-0001-8576-99835044-2701RyabinkinaYulia V.РябинкинаЮлия Валерьевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

ryabinkina11@mail.ruhttps://orcid.org/0000-0001-6026-33887248-1282GnedovskayaElena V.ГнедовскаяЕлена Владимировна
Russian Federation

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

д-р мед. наук, профессор, член-корреспондент РАН

gnedovskaya@neurology.ruhttps://orcid.org/0009-0006-6162-2665BokarevSergey A.БокаревСергей Александрович
Russian Federation
beaucuriets@gmail.comRussian Center of Neurology and NeurosciencesРоссийский центр неврологии и нейронаукPeoples’ Friendship University of RussiaРоссийский университет дружбы народов имени Патриса ЛумумбыMother and Child Clinic, MoscowКлиника «Мать и дитя», Москва29042026120520263221661791901202609022026Copyright ©; 2026, Eco-VectorCopyright ©; 2026, Эко-Вектор2026Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://medjrf.com/0869-2106/article/view/701300

Pupillary reflex parameters reflect the functional state of the visual pathway and the nervous system as a whole. An accurate, objective, and easily reproducible method for assessing these parameters is pupillometry—a quantitative analysis of pupillary response dynamics to light stimulation. We searched the international PubMed and EMBASE databases as well as the Russian eLIBRARY.RU database, identifying case reports, original research studies, and systematic reviews.

Current research demonstrates growing interest in pupillometry as a diagnostic method for pupillary abnormalities in ophthalmological and neurological diseases. Previously used primarily in neurology, it has been actively introduced into ophthalmological practice in recent years. Moreover, pupillometry demonstrates high sensitivity to early ophthalmological changes in conditions such as age-related macular degeneration, glaucoma, and diabetic retinopathy—changes that often precede structural damage detected by optical coherence tomography or perimetry. Additionally, in unilateral optic nerve lesions, pupillometry enables the identification of compensatory mechanisms in the healthy eye, driven by adaptation of intrinsically photosensitive retinal ganglion cells (ipRGCs).

Studies show that quantitative pupillary reflex parameters and derived indices are successfully used for diagnosis, prognosis, and treatment selection in brain lesions. Pupillometry not only helps identify post-stroke complications but also aids in suspecting stroke during emergency care, predicting outcomes of traumatic brain injury, optimizing treatment, and monitoring brain function recovery.

Automated pupillometry holds promise for the diagnosis and monitoring of both ophthalmological and neurological diseases. Further research will expand its application and improve data analysis algorithms.

Параметры зрачкового рефлекса отражают функциональное состояние зрительного анализатора и нервной системы в целом. Точным, объективным и легко воспроизводимым методом их оценки является пупиллометрия — количественный анализ динамики зрачковой реакции на световое воздействие. Нами осуществлён поиск литературы в международных базах данных PubMed и EMBASE, а также в российской базе eLIBRARY.RU, в результате которого были отобраны описания клинических случаев, оригинальные исследовательские работы и систематические обзоры.

Современные исследования демонстрируют растущий интерес к пупиллометрии как методу диагностики зрачковых нарушений при офтальмологических и неврологических заболеваниях. Ранее используемая преимущественно в неврологии, она в последние годы активно внедряется и в офтальмологическую практику. Более того, пупиллометрия демонстрирует высокую чувствительность к ранним офтальмологическим изменениям при таких заболеваниях, как возрастная макулярная дегенерация, глаукома и диабетическая ретинопатия, которые часто предшествуют структурным повреждениям, выявляемым с помощью оптической когерентной томографии или периметрии. Кроме того, при односторонних поражениях зрительного нерва пупиллометрия позволяет выявить компенсаторные механизмы со стороны здорового глаза, обусловленные адаптацией внутренних фоточувствительных ганглиозных клеток сетчатки.

Исследования показывают, что количественные параметры зрачкового рефлекса и производные от них индексы успешно применяются для диагностики, прогнозирования и выбора тактики лечения при поражениях головного мозга. Пупиллометрия помогает не только выявлять постинсультные осложнения, но и подозревать инсульт уже на этапе экстренной помощи, а также прогнозировать исходы черепно-мозговых травм, оптимизировать лечение и отслеживать восстановление функций мозга.

Автоматизированная пупиллометрия перспективна для диагностики и мониторинга как офтальмологических, так и неврологических заболеваний. Дальнейшие исследования позволят расширить её применение и улучшить алгоритмы анализа данных.

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