B 型超声对相对传入性瞳孔障碍的客观评估。
Objective assessment of a relative afferent pupillary defect by B-mode ultrasound.
机构信息
Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany.
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany.
出版信息
PLoS One. 2018 Aug 27;13(8):e0202774. doi: 10.1371/journal.pone.0202774. eCollection 2018.
PURPOSE
To evaluate B-mode ultrasound as a novel method for objective and quantitative assessment of a relative afferent pupillary defect (RAPD) in a prospective case-control study.
METHODS
Seventeen patients with unilateral optic neuropathy and a clinically detectable RAPD and 17 age and sex matched healthy controls were examined with B-mode ultrasound using an Esaote-Mylab25 system according to current guidelines for orbital insonation. The swinging flashlight test was performed during ultrasound assessment with a standardized light stimulus using a penlight.
RESULTS
B-mode ultrasound RAPD examination was doable in approximately 5 minutes only and was well tolerated by all participants. Compared to the unaffected contralateral eyes, eyes with RAPD showed lower absolute constriction amplitude of the pupillary diameter (mean [SD] 0.8 [0.4] vs. 2.1 [0.4] mm; p = 0.009) and a longer pupillary constriction time after ipsilateral light stimulus (mean [SD] 1240 [180] vs. 710 [200] ms; p = 0.008). In eyes affected by RAPD, visual acuity correlated with the absolute constriction amplitude (r = 0.75, p = 0.001).
CONCLUSIONS
B-mode ultrasound enables fast, easy and objective quantification of a RAPD and can thus be applied in clinical practice to document a RAPD.
目的
在一项前瞻性病例对照研究中，评估 B 型超声作为一种客观、定量评估相对传入性瞳孔障碍（RAPD）的新方法。
方法
对 17 例单侧视神经病变且临床检测到 RAPD 的患者和 17 名年龄和性别匹配的健康对照者，使用 Esaote-Mylab25 系统，按照目前的眶内超声检查指南，进行 B 型超声检查。在超声检查过程中，使用笔灯进行标准光刺激，同时进行摆动闪光灯测试。
结果
B 型超声 RAPD 检查仅需约 5 分钟即可完成，且所有参与者均能很好地耐受。与未受影响的对侧眼相比，RAPD 眼的瞳孔直径绝对收缩幅度较低（平均值[标准差]为 0.8[0.4] vs. 2.1[0.4]mm；p=0.009），同侧光刺激后的瞳孔收缩时间更长（平均值[标准差]为 1240[180] vs. 710[200]ms；p=0.008）。在受 RAPD 影响的眼中，视力与绝对收缩幅度相关（r=0.75，p=0.001）。
结论
B 型超声能快速、简便、客观地定量评估 RAPD，因此可在临床实践中用于记录 RAPD。
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