Atik Sevinc, Koc Feray, Kaplan Yusuf Cem, Yurtseven Süreyya Gül
Department of Ophthalmology.
Department of Pharmacology.
Neuroophthalmology. 2014 Apr 25;38(3):153-155. doi: 10.3109/01658107.2014.894089. eCollection 2014.
A 34-year-old woman was hospitalised with acute onset nausea, vomiting, ataxia, nystagmus, blurred vision, and bilateral mydriasis. Toxicologic investigations and serologic tests for infectious aetiologies were negative. Demyelinating disease was suspected based on magnetic resonance imaging (MRI) findings but there were no lesions at the midbrain explaining bilateral mydriasis. Direct light, consensual light, and near responses for pupil were all negative. Biomicroscopic examination of the iris did not show any sphincter damage or tonic movements. Pupils didn't respond to pilocarpine (0.1% and 2%) and remained unresponsive during the follow-up period. Congenital mydriasis was diagnosed because old photographs revealed that pupils were dilated previously.
一名34岁女性因急性发作的恶心、呕吐、共济失调、眼球震颤、视力模糊和双侧瞳孔散大入院。毒理学检查和感染病因的血清学检测均为阴性。基于磁共振成像（MRI）结果怀疑为脱髓鞘疾病，但中脑没有病变可解释双侧瞳孔散大。瞳孔的直接对光反射、间接对光反射和近反射均为阴性。虹膜生物显微镜检查未显示任何括约肌损伤或强直性运动。瞳孔对毛果芸香碱（0.1%和2%）无反应，在随访期间仍无反应。由于旧照片显示瞳孔先前就已散大，故诊断为先天性瞳孔散大。
