Chalam Kakarla V, Gupta Shailesh K, Brar Vikram S
Department of Ophthalmology, University of Florida Health Science Center, Jacksonville, FL, USA.
Clin Ophthalmol. 2008 Mar;2(1):207-10. doi: 10.2147/opth.s2247.
We present a case of an 18 year old white male with Burkitt's lymphoma who was operated on for hydrocephalus and subsequently referred for evaluation of new onset diplopia. On examination, his visual acuity (VA) was 20/20 in both eyes with a right superior oblique palsy. His pupillary reaction to light was intact while on near gaze there was no constriction of the pupils, bilaterally. The other two responses of the near gaze triad ie, convergence and accommodation were present. These findings were suggestive of an Inverse Argyll Robertson pupil (IARP), a rare entity in the literature. We could not find a specific cause attributable to this manifestation in this patient, though we feel it may be secondary to infiltration from Burkitt's lymphoma and/or compression from elevated intracranial pressure of the efferent pupillary near reflex pathway.
我们报告一例18岁白人男性伯基特淋巴瘤患者，该患者因脑积水接受手术，随后因新发复视而前来评估。检查发现，他双眼视力（VA）均为20/20，伴有右上斜肌麻痹。他的瞳孔对光反应正常，但近凝视时双侧瞳孔无收缩。近凝视三联征的其他两个反应，即集合和调节存在。这些发现提示为反向阿盖尔·罗伯逊瞳孔（IARP），这在文献中是一种罕见的情况。尽管我们认为这可能继发于伯基特淋巴瘤的浸润和/或传出瞳孔近反射通路颅内压升高的压迫，但在该患者中我们未能找到可归因于这种表现的具体原因。
