Hashimoto-Takahashi E
Department of Ophthalmology, Osaka Medical College, Japan.
Bull Osaka Med Coll. 1990 Nov;36(1-2):71-7.
In patients with primary open angle glaucoma (POAG), the evaluation of neurological status is clinically important. A detailed analysis of the pupillary dynamics under the control of the autonomic nervous system was performed in patients with POAG. Pupil size and pupillary light reflex were measured by an infrared videopupillogram in 13 patients with POAG (from 25 to 67 years old) with good oculotensive controls without applications mydriatics nor miotics revealed. Pupillary light reflexes were analyzed by comparing the simulated patterns obtained after the studies with topical autonomic agents. Effects of topical adrenergics (dipivalyl epinephrine: DPE 0.025%) on the pupil were also investigated. Three types of autonomic abnormalities (cholinergic, adrenergic and physiological mydriatic reflex patterns) of the light reflex were detected in 11 eyes of 6 patients, and a normal pattern was found in only 2 eyes of one patient. Afferent pupillary defect (APD) pattern was detected in 13 eyes. Although APD was generally described as a reduced visual input, the degree of APD was not related to the stage of the visual field defect in POAG.
在原发性开角型青光眼（POAG）患者中，神经学状态评估在临床上具有重要意义。对POAG患者自主神经系统控制下的瞳孔动态进行了详细分析。通过红外视频瞳孔图测量了13例POAG患者（年龄25至67岁）的瞳孔大小和瞳孔对光反射，这些患者眼压控制良好，未使用散瞳剂或缩瞳剂。通过比较使用局部自主神经药物研究后获得的模拟模式来分析瞳孔对光反射。还研究了局部肾上腺素能药物（双特戊酰肾上腺素：DPE 0.025%）对瞳孔的影响。在6例患者的11只眼中检测到三种类型的光反射自主神经异常（胆碱能、肾上腺素能和生理性散瞳反射模式），仅在1例患者的2只眼中发现正常模式。在13只眼中检测到传入性瞳孔缺陷（APD）模式。尽管APD通常被描述为视觉输入减少，但APD的程度与POAG患者视野缺损的阶段无关。
