Gronow T, Zangemeister W H
Neurologische Klinik, Universitätsklinik Eppendorf, Hamburg.
Klin Monbl Augenheilkd. 1999 Aug;215(2):99-103. doi: 10.1055/s-2008-1034680.
To examine effects of diabetes mellitus on the pupillary light reflex it was analysed using a new compact integrated infrared pupillograph (CIP). PATIENTS AN METHODS: We examined 52 patients with diabetes mellitus and 21 control subjects. The initial pupillary diameter was diminished in the group of the diabetics. This was the only parameter that was significantly diminished in the group of all patients with diabetes mellitus. The maximal constriction velocity, the maximal velocity of the first part of the redilation, the reflex amplitude and the latency time were significantly reduced only in those patients showing also signs of autonomic neuropathy of the cardiovascular system. The amplitude and the velocities however, measured as part of the initial pupillary diameter showed no significant reduction.
This leads to a very crucial question when examining the pupillary reflex of diabetics. Which alterations are due to the pathological small pupil and which are directly due to autonomic neuropathy. This study shows that the diminished pupillary diameter after adaptation to the dark is an early sign of autonomic neuropathy; other alterations in the pupillary reflex can be seen after other symptoms of the autonomic neuropathy are shown as well.
为了研究糖尿病对瞳孔光反射的影响,使用一种新型紧凑型集成红外瞳孔仪(CIP)进行分析。患者与方法:我们检查了52例糖尿病患者和21名对照受试者。糖尿病患者组的初始瞳孔直径减小。这是所有糖尿病患者组中唯一显著减小的参数。仅在那些同时表现出心血管系统自主神经病变体征的患者中,最大收缩速度、首次再扩张第一部分的最大速度、反射幅度和潜伏时间显著降低。然而,作为初始瞳孔直径一部分测量的幅度和速度没有显著降低。
在检查糖尿病患者的瞳孔反射时,这引出了一个非常关键的问题。哪些改变是由于病理性小瞳孔引起的,哪些是直接由自主神经病变引起的。本研究表明,适应黑暗后瞳孔直径减小是自主神经病变的早期迹象;在出现自主神经病变的其他症状后,也可以看到瞳孔反射的其他改变。