Barbur J L, Hess R F, Pinney H D
Applied Vision Research Centre, City University, London, UK.
Ophthalmic Physiol Opt. 1994 Apr;14(2):139-49. doi: 10.1111/j.1475-1313.1994.tb00102.x.
Quantitative measurements of pupillary function (response amplitude and latency) were made for normal eyes and for normal and fellow amblyopic eyes of groups of strabismic and anisometropic amblyopes. Stimuli consisted of luminance modulation of a large, evenly lit area (pupil light reflex) as well as contrast modulation of sinusoidal gratings (pupil grating response) of fixed, space-averaged luminance. Measurements were made of the direct and the consensual reflex under monocular stimulation. A comparison of the amplitude of the pupil light reflex as a function of luminance modulation showed no significant differences between normal and fellow amblyopic eyes for both the strabismic and anisometropic groups of amblyopes studied. A similar comparison of the associated response latencies showed significant difference between normal and fellow amblyopic eyes for both groups. In general, reductions in response amplitude and latency of the pupil grating response were found in individuals from each group when comparing the good and the affected eyes, although the observed group differences were only significant in the strabismic group. Interestingly, statistically significant reductions in both amplitude and latency for both the pupil light reflex and the pupil grating response were found between the eyes of normal observers and the so-called normal eyes of amblyopes in both groups studied. These results suggest that the type of pupillary deficit in amblyopia is a complicated one, depending not only on the type of amblyopia (strabismic or anisometropic) and the type of stimulus employed (light or pattern), but also on the parameter assessed (amplitude or latency) and whether the amblyopic result is referenced to its fellow normal eye or to the normal eye of a non-amblyopic observer. Since the pupil response to light flux changes is not mediated exclusively via the retinal projection to the midbrain and may also involve the activity of central visual pathways, the results obtained in this study cannot be used to provide definitive evidence for the site of abnormality in amblyopia.
对斜视性和屈光参差性弱视患者群体的正常眼睛以及正常和患侧弱视眼进行了瞳孔功能的定量测量（反应幅度和潜伏期）。刺激包括大面积均匀照明区域的亮度调制（瞳孔光反射）以及固定的空间平均亮度的正弦光栅的对比度调制（瞳孔光栅反应）。在单眼刺激下测量了直接和间接反射。对作为亮度调制函数的瞳孔光反射幅度进行比较，结果显示，在所研究的斜视性和屈光参差性弱视患者群体中，正常眼和患侧弱视眼之间没有显著差异。对相关反应潜伏期进行的类似比较显示，两组的正常眼和患侧弱视眼之间存在显著差异。一般来说，在比较每组患者的健眼和患眼时，发现每组患者的瞳孔光栅反应的幅度和潜伏期都有所降低，尽管观察到的组间差异仅在斜视组中具有统计学意义。有趣的是，在所研究的两组中，正常观察者的眼睛与弱视患者的所谓正常眼之间，瞳孔光反射和瞳孔光栅反应的幅度和潜伏期均出现了具有统计学意义的降低。这些结果表明，弱视中的瞳孔缺陷类型很复杂，不仅取决于弱视类型（斜视性或屈光参差性）和所采用的刺激类型（光或图案），还取决于所评估的参数（幅度或潜伏期），以及弱视结果是参照其健侧正常眼还是非弱视观察者的正常眼。由于瞳孔对光通量变化的反应并非仅通过视网膜向中脑的投射介导，还可能涉及中枢视觉通路的活动，因此本研究获得的结果不能用于为弱视异常部位提供确凿证据。
