Kardon R H, Denison C E, Brown C K, Thompson H S
Department of Ophthalmology, University of Iowa Hospital, Iowa City 52242.
Arch Ophthalmol. 1990 Mar;108(3):384-7. doi: 10.1001/archopht.1990.01070050082036.
We evaluated the effectiveness of the cocaine test for diagnosing Horner's syndrome. The test was administered to 119 patients with a diagnosis of Horner's syndrome and to 50 normal subjects. We compared the cocaine-induced anisocoria in the two groups by measuring photographs of the pupils. We found the cocaine test to be highly effective in separating normal subjects from patients with Horner's syndrome. The chances of having Horner's syndrome increased with the amount of cocaine-induced anisocoria. Through the use of logistic regression analysis, we determined the odds ratio of having Horner's syndrome compared with not having it for each 0.1-mm increment of anisocoria measured after cocaine administration. A postcocaine anisocoria value of 0.8 mm gave a mean odds ratio of approximately 1050:1 that Horner's syndrome was present (lower 95% confidence limit = 37:1). We found that simply measuring the postcocaine anisocoria provided a better prediction of Horner's syndrome than taking the trouble to calculate the net change in anisocoria. Odds ratios should help the clinician decide if the result of a cocaine test is indicative of Horner's syndrome.
我们评估了可卡因试验对诊断霍纳综合征的有效性。该试验应用于119例诊断为霍纳综合征的患者以及50名正常受试者。我们通过测量瞳孔照片比较了两组中可卡因诱导的瞳孔不等大情况。我们发现可卡因试验在区分正常受试者与霍纳综合征患者方面非常有效。患霍纳综合征的几率随着可卡因诱导的瞳孔不等大程度增加而升高。通过逻辑回归分析，我们确定了可卡因给药后每增加0.1毫米瞳孔不等大程度，患霍纳综合征与未患霍纳综合征的比值比。可卡因给药后瞳孔不等大值为0.8毫米时，霍纳综合征存在的平均比值比约为1050:1（95%置信下限 = 37:1）。我们发现，简单测量可卡因给药后的瞳孔不等大情况比费心计算瞳孔不等大的净变化能更好地预测霍纳综合征。比值比应有助于临床医生判断可卡因试验结果是否提示霍纳综合征。
