van der Wiel H L, van Gijn J
Department of Neurology, University Hospital Rotterdam, The Netherlands.
Clin Neurol Neurosurg. 1988;90(2):103-8. doi: 10.1016/s0303-8467(88)80026-x.
We studied the accuracy of the clinical diagnosis of Horner's syndrome in 62 patients. The final criterion was serial photography of the darkness reflex of the pupil. This technique confirmed oculosympathetic dysfunction in only 50%. The positive predictive value of the clinical diagnosis could be increased to more than 80% by measuring the degree of miosis and ptosis on single photographs, or by assuming independent confirmation of the clinical diagnosis by a second observer. However, the chance that a patient who is judged normal in this way does still have oculosympathetic dysfunction remains 25% (photographs) to 40% (second observer). Testing with cocaine is more specific and slightly more sensitive than estimating or measuring the degree of miosis and ptosis.
我们研究了62例霍纳综合征患者临床诊断的准确性。最终标准是对瞳孔暗反射进行系列摄影。该技术仅在50%的患者中证实了眼交感神经功能障碍。通过在单张照片上测量瞳孔缩小和上睑下垂的程度，或假设由第二位观察者独立确认临床诊断，临床诊断的阳性预测值可提高到80%以上。然而，以这种方式被判定为正常的患者仍存在眼交感神经功能障碍的可能性为25%（摄影）至40%（第二位观察者）。与评估或测量瞳孔缩小和上睑下垂的程度相比，可卡因试验更具特异性，敏感性也略高。
