Lüdtke H, Kriegbaum C, Leo-Kottler B, Wilhelm H
Universitäts-Augenklinik Tübingen, Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie, Germany.
Graefes Arch Clin Exp Ophthalmol. 1999 Mar;237(3):207-11. doi: 10.1007/s004170050220.
According to a recent pupillographic study, patients with Leber's hereditary optic neuropathy (LHON) show the same pupillary behaviour as normals. Because this raises many questions concerning the real nature of LHON and challenges our concept of the afferent pupillary system, we tried to verify the results of this study.
Pupillary function was assessed in 34 normal subjects and 40 patients with LHON. Pupillary light reflexes were recorded by means of the Compact Integrated Pupillograph (CIP, AMTech). Under mesopic conditions 200-ms stimuli were presented at two different stimulus intensities. Latency, constriction amplitude and baseline diameter were defined automatically. Pupil light reflexes were compared between LHON patients and normals and between the better and the worse eye in 20 LHON patients with different visual acuities.
For both stimuli there were significant differences in latency between LHON patients and controls. The latency of the pupil light reflex proved to be about 20 ms longer for LHON patients, and the amplitude was significantly smaller for the bright stimulus. Within LHON patients, the eyes with the worse visual acuity had a significantly smaller constriction amplitude than the eyes with the better visual acuity.
The results of our study confirm that LHON really is an optic nerve disease and that the pupillary light reflexes are not normal.
根据最近一项瞳孔描记研究，莱伯遗传性视神经病变（LHON）患者表现出与正常人相同的瞳孔行为。由于这引发了许多关于LHON本质的问题，并对我们传入性瞳孔系统的概念提出了挑战，我们试图验证该研究结果。
对34名正常受试者和40名LHON患者的瞳孔功能进行评估。通过紧凑型集成瞳孔描记仪（CIP，AMTech）记录瞳孔对光反射。在中度照明条件下，以两种不同的刺激强度呈现200毫秒的刺激。自动定义潜伏期、收缩幅度和基线直径。比较了LHON患者与正常人之间以及20名视力不同的LHON患者中较好眼和较差眼之间的瞳孔对光反射。
对于两种刺激，LHON患者与对照组之间的潜伏期均存在显著差异。LHON患者的瞳孔对光反射潜伏期延长约20毫秒，明亮刺激下的幅度显著较小。在LHON患者中，视力较差的眼睛收缩幅度明显小于视力较好的眼睛。
我们的研究结果证实LHON确实是一种视神经疾病，且瞳孔对光反射不正常。
