Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, China.
Ophthalmic Res. 2012;47(3):113-21. doi: 10.1159/000330049. Epub 2011 Oct 11.
To determine whether the pupillary light reflex (PLR) can serve as an indicator of photoreceptor function in patients with advanced typical retinitis pigmentosa (RP).
Dark-adapted transient PLRs elicited by blue or white light over a luminance range of 4 log units were recorded from 27 eyes of 19 patients with advanced RP. Retinas were characterized according to fundus autofluorescence (AF) and dark-adapted perimetry. We qualitatively analyzed whether PLR thresholds were correlated with AF patterns or scotopic sensitivity. Quantitative analysis included correlations between relative pupillary constrictions (RPCs) elicited by blue light (≤-1 log cd/m(2)) and the area of abnormal ring or central AF, and between RPCs elicited by white light and perimetric mean sensitivity.
The PLRs of all patients showed varying degrees of threshold elevation and relative afferent pupil defects. We classified three types of abnormal fundus AF: abnormal ring AF, abnormal central AF, and fragmentary AF. PLR thresholds were largely consistent with the patterns of AF and scotopic sensitivity. Rod-mediated RPCs were not correlated with the area of the abnormal ring AF (p > 0.05), but were correlated with the area of abnormal central AF (p < 0.05). RPCs elicited with a white stimulus (-0.3 or 0.7 log cd/m(2)) were significantly correlated with the mean sensitivity of the dark-adapted perimetry.
PLR testing is a powerful technique for assessing photoreceptor dysfunction. The high correlation with AF and dark-adapted perimetry suggests that the key to quantifying photoreceptor function using the transient PLR is to optimize the luminance of the stimulus.
确定瞳孔光反射（PLR）是否可以作为晚期典型色素性视网膜炎（RP）患者光感受器功能的指标。
从 19 例晚期 RP 患者的 27 只眼中记录了暗适应时由蓝光或白光引起的瞬态 PLR，亮度范围为 4 个对数单位。根据眼底自发荧光（AF）和暗适应视野检查来描述视网膜。我们定性分析 PLR 阈值是否与 AF 模式或暗适应敏感度相关。定量分析包括蓝光（≤-1 log cd/m2）引起的相对瞳孔收缩（RPC）与异常环或中央 AF 的面积之间的相关性，以及白光引起的 RPCs 与视野平均敏感度之间的相关性。
所有患者的 PLR 均显示出不同程度的阈值升高和相对传入瞳孔缺陷。我们将异常的眼底 AF 分为三种类型：异常环 AF、异常中央 AF 和碎片状 AF。PLR 阈值与 AF 和暗适应敏感度模式基本一致。杆状介导的 RPC 与异常环 AF 的面积无关（p > 0.05），但与异常中央 AF 的面积相关（p < 0.05）。用白色刺激（-0.3 或 0.7 log cd/m2）引起的 RPC 与暗适应视野检查的平均敏感度显著相关。
PLR 测试是评估光感受器功能障碍的有力技术。与 AF 和暗适应视野检查的高度相关性表明，使用瞬态 PLR 量化光感受器功能的关键是优化刺激的亮度。
