Bitirgen Gülfidan, Daraghma Mohammed, Özkağnıcı Ahmet
Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
Reyhanlı Sevgi Hospital, Clinic of Ophthalmology, Hatay, Turkey
Turk J Ophthalmol. 2019 Dec 31;49(6):310-314. doi: 10.4274/tjo.galenos.2019.32748.
To evaluate the pupillary light reflex responses in patients with unilateral strabismic and anisometropic amblyopia using dynamic pupillometry.
A total of 102 eyes of 51 patients with unilateral amblyopia were included in this cross-sectional study. Of the 51 patients, 37 (72.5%) had strabismic amblyopia and 14 (27.5%) had anisometropic amblyopia. All patients underwent complete ophthalmological examination, and pupillary light reflex responses were measured using a computerized dynamic pupillometry system (MonPack One; Metrovision, France). Initial pupil diameter; the amplitude, latency, duration, and velocity of pupil contraction; and the latency, duration, and velocity of pupil dilation were recorded. Results obtained from the patients’ amblyopic and normal fellow eyes were compared using paired-samples t-test and Wilcoxon signed rank test.
The mean age of the patients was 11.9±6.0 years. Amblyopic eyes had longer contraction latency (p=0.009), shorter contraction duration (p=0.002), and higher dilation velocity (p=0.033) compared to fellow eyes, while other parameters did not show significant differences. In subgroup analysis, eyes with strabismic amblyopia had longer contraction latency (p=0.006) and shorter contraction duration (p=0.017), while eyes with anisometropic amblyopia had shorter contraction duration (p=0.030) when compared with fellow eyes.
In this study, the objective records obtained by dynamic pupillometry showed that pupillary light reflex responses are affected in amblyopic eyes. This finding may shed light on unclear aspects of the pathophysiology of amblyopia.
使用动态瞳孔测量法评估单侧斜视性和屈光参差性弱视患者的瞳孔光反射反应。
本横断面研究纳入了51名单侧弱视患者的102只眼。在这51名患者中，37名（72.5%）患有斜视性弱视，14名（27.5%）患有屈光参差性弱视。所有患者均接受了全面的眼科检查，并使用计算机化动态瞳孔测量系统（MonPack One；法国Metrovision公司）测量瞳孔光反射反应。记录初始瞳孔直径、瞳孔收缩的幅度、潜伏期、持续时间和速度，以及瞳孔扩张的潜伏期、持续时间和速度。使用配对样本t检验和Wilcoxon符号秩检验比较患者弱视眼和健侧眼的结果。
患者的平均年龄为11.9±6.0岁。与健侧眼相比，弱视眼的收缩潜伏期更长（p=0.009），收缩持续时间更短（p=0.002），扩张速度更高（p=0.033），而其他参数无显著差异。在亚组分析中，与健侧眼相比，斜视性弱视眼的收缩潜伏期更长（p=0.006），收缩持续时间更短（p=0.017），而屈光参差性弱视眼的收缩持续时间更短（p=0.030）。
在本研究中，动态瞳孔测量法获得的客观记录表明弱视眼的瞳孔光反射反应受到影响。这一发现可能为弱视病理生理学中尚不明确的方面提供线索。
