Udry Morgane, Kardon Randy H, Sadun Federico, Kawasaki Aki
FondationAsile des Aveugles, Department of Biology and Medicine, Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland.
Department of Ophthalmology and Visual Sciences, Iowa City VA Center of Excellence for the Prevention and Treatment of Vision Loss, University of Iowa and Veterans Affairs Hospital, Iowa City, IA, United States.
Front Neurol. 2019 Aug 19;10:846. doi: 10.3389/fneur.2019.00846. eCollection 2019.
Tadpole pupil is a rare phenomenon in which segmental spasm of the iris dilator muscle results in a tadpole-shaped pupil. The pupillary distortion is usually unilateral, lasts several minutes, and can recur in clusters. Any segment of the iris can be affected; thus, for some patients, a different-shaped tadpole pupil is noticed from episode to episode. Tadpole pupil most commonly appears spontaneously in young women. Tadpole pupil is not associated with any systemic disorders, but an ipsilateral Horner syndrome is noted in 46% of patients. In this article, we have reviewed the existing literature of tadpole pupil, compiling all the published cases in a table and reporting four additional cases to re-examine the clinical profile of this disorder and to consider the different purported mechanisms as means to understand its possible etiology and treatment. The common denominator in the pathophysiology of tadpole pupil is a focal excessive contraction (segmental spasm) of the iris dilator muscle. Based on various proposed pathophysiologic mechanism of tadpole pupil, we can consider potential forms of treatment.
蝌蚪样瞳孔是一种罕见现象，其中虹膜开大肌的节段性痉挛导致瞳孔呈蝌蚪状。瞳孔变形通常为单侧，持续数分钟，并可成簇复发。虹膜的任何节段都可能受累；因此，对于一些患者来说，每次发作时会注意到不同形状的蝌蚪样瞳孔。蝌蚪样瞳孔最常见于年轻女性自发出现。蝌蚪样瞳孔与任何全身性疾病均无关联，但46%的患者存在同侧霍纳综合征。在本文中，我们回顾了蝌蚪样瞳孔的现有文献，将所有已发表的病例整理成表格，并报告另外4例病例，以重新审视该疾病的临床特征，并考虑不同的假定机制，作为理解其可能病因和治疗方法的手段。蝌蚪样瞳孔病理生理学的共同特征是虹膜开大肌的局灶性过度收缩（节段性痉挛）。基于蝌蚪样瞳孔各种提出的病理生理机制，我们可以考虑潜在的治疗形式。
