Hreidarsson A B, Gundersen H J
Second University Clinic of Internal Medicine, Aarhus Kommune-hospital, Denmark.
Diabetes. 1988 Apr;37(4):446-51. doi: 10.2337/diab.37.4.446.
Pupillary unrest (fluctuations in pupil size) was measured by infrared television videopupillography in 80 insulin-dependent diabetic patients (age 25-43 yr, diabetes duration 0-35 yr) and 26 control subjects (age 26-39 yr). In darkness, pupillary unrest was 21% less in diabetic subjects than in controls. During prolonged and brief illumination, pupillary unrest was 35 and 37% less in diabetic subjects than in controls, respectively, and in both cases the unrest was inversely correlated to the duration of diabetes. There were inverse correlations between 1) vibratory perception threshold, long-term high blood glucose levels, and severity of retinopathy, and 2) pupillary unrest in darkness and during prolonged illumination. The fractional reduction in pupil size (relative miosis) was 19% less during prolonged illumination in diabetic subjects than in controls and was positively correlated to the pupillary unrest in both groups. For a given fractional reduction in pupil size during illumination, diabetic subjects still had a smaller unrest than controls. Pupil size in darkness was 19% smaller in diabetic subjects than in controls, and in diabetic subjects it was positively correlated to the unrest in darkness and during prolonged and brief illumination. None of the pupillary abnormalities showed correlation to biomicroscopic changes in the iris. The autonomic nervous system abnormalities reflected in the pupil in longstanding diabetes are 1) a reduction in pupillary unrest in light and in darkness, more pronounced in light, 2) a reduction in the ability to maintain miosis in continuous light, and 3) a reduction in size.
采用红外电视视频瞳孔描记术对80例胰岛素依赖型糖尿病患者（年龄25 - 43岁，糖尿病病程0 - 35年）及26名对照者（年龄26 - 39岁）的瞳孔活动（瞳孔大小波动）进行测量。在黑暗中，糖尿病患者的瞳孔活动比对照者少21%。在长时间和短时间光照期间，糖尿病患者的瞳孔活动分别比对照者少35%和37%，且在这两种情况下，瞳孔活动均与糖尿病病程呈负相关。1）振动觉阈值、长期高血糖水平与视网膜病变严重程度之间，以及2）黑暗中和长时间光照期间的瞳孔活动之间存在负相关。在长时间光照期间，糖尿病患者瞳孔大小的缩小分数（相对瞳孔缩小）比对照者少19%，且与两组的瞳孔活动呈正相关。对于光照期间给定的瞳孔大小缩小分数，糖尿病患者的瞳孔活动仍比对照者小。糖尿病患者在黑暗中的瞳孔大小比对照者小19%，且在糖尿病患者中，其与黑暗中和长时间及短时间光照期间的瞳孔活动呈正相关。所有瞳孔异常均与虹膜的生物显微镜变化无关。长期糖尿病患者瞳孔所反映的自主神经系统异常为：1）光照和黑暗中瞳孔活动减少，在光照中更明显；2）在持续光照下维持瞳孔缩小的能力降低；3）瞳孔大小减小。
