Department of Ophthalmology, Kangwon National University Graduate School of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Korea.
Sci Rep. 2021 May 12;11(1):10089. doi: 10.1038/s41598-021-89148-w.
We have compared the diagnostic ability of different concentrations of 0.125% and 0.0625% dilute pilocarpine for detecting denervation supersensitivity in unilateral Adie's tonic pupil. This retrospective, observational, case-control study involved 117 subjects, consisting of 56 patients with unilateral Adie's tonic pupil and 61 controls with other causes of unilateral dilated pupils. Subjects underwent the dilute pilocarpine test with one of the two concentrations, 0.125% or 0.0625%. Pupillary light reflex was recorded with a dynamic pupillometer at baseline and at 30-40 min after instilling one of the two concentrations of dilute pilocarpine. Diagnostic accuracy of two different concentrations of the dilute pilocarpine test, 0.125% group versus 0.0625% group, were compared by area under the receiver operating characteristic curve (AUC). Diagnostic ability of the dilute pilocarpine test for detecting denervation supersensitivity in unilateral Adie's tonic pupil was significantly better in the 0.0625% group than in the 0.125% group (AUC = 0.954 vs. 0.840, respectively, P = 0.047). In the 0.0625% group, the change in maximal pupil diameter of ≥ 0.5 mm after topical pilocarpine instillation showed 100% sensitivity and 82.8% specificity for detecting Adie's tonic pupil. This study confirmed that pupillary constriction with 0.0625% pilocarpine is better than 0.125% pilocarpine for detecting denervation supersensitivity in Adie's tonic pupil. Digital pupillometry is a reliable method for assessing denervation supersensitivity in Adie's tonic pupil.
我们比较了 0.125%和 0.0625%两种不同浓度的毛果芸香碱在检测单侧强直性瞳孔去神经超敏中的诊断能力。这项回顾性、观察性、病例对照研究共纳入 117 名受试者，包括 56 例单侧强直性瞳孔患者和 61 例其他原因导致单侧瞳孔扩大的对照者。受试者分别接受 0.125%或 0.0625%两种浓度稀释毛果芸香碱测试。在基线和滴注两种稀释毛果芸香碱浓度后 30-40 分钟，使用动态瞳孔计记录瞳孔光反射。通过受试者工作特征曲线（ROC）下面积比较两种不同浓度稀释毛果芸香碱试验（0.125%组与 0.0625%组）的诊断准确性。结果显示，0.0625%组的诊断能力显著优于 0.125%组（AUC 分别为 0.954 比 0.840，P=0.047）。在 0.0625%组中，滴入毛果芸香碱后最大瞳孔直径变化≥0.5mm 的患者，其检测强直性瞳孔的敏感性为 100%，特异性为 82.8%。本研究证实，0.0625%的毛果芸香碱比 0.125%的毛果芸香碱更能检测出强直性瞳孔的去神经超敏。数字瞳孔测量是评估强直性瞳孔去神经超敏的可靠方法。
