Bell R A, Waggoner P M, Boyd W M, Akers R E, Yee C E
Department of Ophthalmology, Medical College of Georgia, Augusta.
Arch Ophthalmol. 1993 Jul;111(7):938-42. doi: 10.1001/archopht.1993.01090070056019.
To assess the validity and reproducibility of quantitating relative afferent pupillary defects with the swinging flashlight test, using a 3-second pause technique, and to compare this grading system with that using neutral density filters.
We prospectively studied patients with relative afferent pupillary defects by using the swinging flashlight test with a standardized illumination time of 3 seconds (pause time) for each eye. Each relative afferent pupillary defect was graded as follows: grade I, a weak initial constriction and greater redilatation; grade II, initial stall and greater redilatation; grade III, immediate pupillary dilatation; grade IV, immediate pupillary dilatation following prolonged illumination of the good eye for 6 seconds; grade V, immediate pupillary dilatation with no secondary constriction. The grades on the individual resident evaluations were compared with those on the group evaluations, and the grading system was compared with the neutral density filter grading system.
Neuro-ophthalmology service of an urban teaching hospital.
A total of 119 patients.
There was a good correlation in all grades between individual resident and group evaluations, with an overall 78% agreement. The five grades had corresponding values in neutral density filter log units: grade I, 0.4; grade II, 0.7; grade III, 1.1; grade IV, 2.0; and grade V, infinity.
The 3-second pause technique for the swinging flashlight test is a reliable method for the detection and quantitation of relative afferent pupillary defects. The grading system can be compared with the neutral density filter grading system, and each grade has a corresponding value in log units.
采用3秒停顿技术，通过摆动手电筒试验评估定量相对传入性瞳孔障碍的有效性和可重复性，并将该分级系统与使用中性密度滤光片的分级系统进行比较。
我们对患有相对传入性瞳孔障碍的患者进行前瞻性研究，对每只眼睛使用标准化照明时间为3秒（停顿时间）的摆动手电筒试验。每个相对传入性瞳孔障碍按以下方式分级：I级，初始收缩微弱且再扩张明显；II级，初始停顿且再扩张明显；III级，立即瞳孔扩张；IV级，对健眼持续照明6秒后立即瞳孔扩张；V级，立即瞳孔扩张且无二次收缩。将个体住院医师评估的分级与小组评估的分级进行比较，并将该分级系统与中性密度滤光片分级系统进行比较。
城市教学医院的神经眼科服务部门。
共119例患者。
个体住院医师评估与小组评估在所有分级中均具有良好的相关性，总体一致性为78%。五个分级在中性密度滤光片对数单位中有相应的值：I级，0.4；II级，0.7；III级，1.1；IV级，2.0；V级，无穷大。
摆动手电筒试验的3秒停顿技术是检测和定量相对传入性瞳孔障碍的可靠方法。该分级系统可与中性密度滤光片分级系统进行比较，且每个分级在对数单位中有相应的值。
