0.5%阿可乐定在诊断眼部交感神经麻痹中的敏感性和特异性。
The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis.
作者信息
Koc F, Kavuncu S, Kansu T, Acaroglu G, Firat E
机构信息
Kuzgun sok 48/3 Asagi Ayranci, Ankara 06540, Turkey.
出版信息
Br J Ophthalmol. 2005 Nov;89(11):1442-4. doi: 10.1136/bjo.2005.074492.
AIMS
To evaluate the sensitivity and specificity of 0.5% apraclonidine test in the diagnosis of oculosympathetic paresis (OSP).
METHOD
Apraclonidine (0.5%) was administered to 31 eyes, nine with a diagnosis of Horner syndrome (HS), 22 with bilateral OSP caused by diabetes, and to 54 control eyes. All were confirmed with the cocaine test. The effects on pupil diameter and upper eyelid level were observed 1 hour later.
RESULTS
Apraclonidine caused a mean dilation of 2.04 mm (range 1--4.5) (p<0.001) in the pupils with OSP and it caused pupillary constriction in the control eyes with a mean change of -0.14 mm (range 0.5 to --1) (p<0.05). It caused reversal of anisocoria in all HS cases. Its effects on both pupil diameters and upper lid levels differed significantly between the groups (p<0.001). The mean elevation in the upper lid was 1.75 mm (range 1--4) in the OSP group (p<0.001) and 0.61 mm (range 0--3) in the control group (p<0.001).
CONCLUSION
The effect of the apraclonidine (0.5%) test on the pupil diameter was diagnostic for OSP and had at least the same sensitivity and specificity as the cocaine test for the diagnosis of OSP.
目的
评估0.5%阿可乐定试验在诊断眼交感神经麻痹（OSP）中的敏感性和特异性。
方法
对31只眼睛给予0.5%阿可乐定，其中9只诊断为霍纳综合征（HS），22只因糖尿病导致双侧OSP，另有54只作为对照眼。所有病例均通过可卡因试验确诊。1小时后观察对瞳孔直径和上睑位置的影响。
结果
阿可乐定使OSP患者的瞳孔平均扩大2.04mm（范围1 - 4.5）（p<0.001），而使对照眼的瞳孔收缩，平均变化为-0.14mm（范围0.5至-1）（p<0.05）。它使所有HS病例的瞳孔不等大得到逆转。各组之间其对瞳孔直径和上睑位置的影响差异均有统计学意义（p<0.001）。OSP组上睑平均抬高1.75mm（范围1 - 4）（p<0.001），对照组为0.61mm（范围0 - 3）（p<0.001）。
结论
0.5%阿可乐定试验对瞳孔直径的影响可用于诊断OSP，其敏感性和特异性至少与可卡因试验诊断OSP时相同。
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