Skorkovská Karolína, Lüdtke Holger, Wilhelm Helmut, Wilhelm Barbara
Centre for Ophthalmology, Institute of Ophthalmic Research, University of Tübingen, Tübingen, Germany.
Graefes Arch Clin Exp Ophthalmol. 2009 Jun;247(6):847-53. doi: 10.1007/s00417-008-1015-0. Epub 2008 Dec 19.
The aim of our study was to test in a small series of cases if pupil perimetry can prove real concentric visual field loss in retinal degeneration and distinguish from feigned visual field loss.
By means of infrared-video-pupillography, light responses to perimetric stimuli were recorded. The stimulus pattern consisted of 41 stimuli presented in the central 30 degrees visual field. Stimulus intensity was 140 cd/m(2). 5 healthy subjects, 6 patients with retinitis pigmentosa and 2 patients with suspected functional visual field loss were examined.
Pupil perimetry was able to reproduce the visual field in retinitis pigmentosa very well. Normal subjects and patients with suspected feigned visual field loss showed normal pupillomotor fields, different from the findings in retinitis pigmentosa.
This study provides sufficient evidence that pupil campimetry is applicable for differentiating between retinal dystrophy and functional concentric visual field loss. Possible residual light sensitivity of the blind retina due to melanopsin ganglion cells is obviously not sufficient to provide a pupillary light response to perimetric stimuli.
我们研究的目的是在一小系列病例中测试瞳孔视野计是否能证实视网膜变性中真正的同心性视野缺损，并与伪装的视野缺损相区分。
通过红外视频瞳孔描记法，记录对视野计刺激的光反应。刺激模式由在中央30度视野中呈现的41个刺激组成。刺激强度为140 cd/m²。检查了5名健康受试者、6名视网膜色素变性患者和2名疑似功能性视野缺损患者。
瞳孔视野计能够很好地重现视网膜色素变性患者的视野。正常受试者和疑似伪装视野缺损的患者显示瞳孔运动视野正常，这与视网膜色素变性患者的表现不同。
本研究提供了充分的证据表明瞳孔视野计适用于区分视网膜营养不良和功能性同心性视野缺损。由于黑视蛋白神经节细胞导致的盲视网膜可能残留的光敏感性显然不足以对视野计刺激产生瞳孔光反应。
