Isotani H, Fukumoto Y, Kitaoka H, Furukawa K, Ohsawa N, Utsumi T
Division of Internal Medicine, Hirakata City Hospital, Osaka, Japan.
Diabetes Res Clin Pract. 1995 Jul;29(1):43-8. doi: 10.1016/0168-8227(95)01110-y.
Determination of the dark-adapted pupillary area (DAPA) by infrared photography revealed that some diabetic patients show corectopia (oval pupil) in addition to the small DAPA as pupillary abnormalities. The prevalence and clinical details of oval pupil were compared between diabetic patients and healthy subjects. Pupillary light reflexes were also analyzed with an infrared videopupillography in some of the diabetic patients. The healthy subjects were examined for the influence of age on the ratio of the pupillary diameter of the major and minor axes. The ratio was 1.04 +/- 0.02 (mean +/- S.D.) in the healthy subjects, and cases in which the ratio was +2 S.D. or higher than the mean ratio were defined as oval pupil. Oval pupil was observed in 21 (24%) of 86 diabetic patients, and was correlated with heart rate variation (P < 0.05) and DAPA (P < 0.01), which represent an autonomic dysfunction. Quantitative analysis of pupillary light reflexes with an infrared videopupillography revealed that the dark-adapted pupillary area before photic stimulation (P < 0.01) and the maximum %-velocity of constriction (P < 0.05) were significantly less in the oval pupil group than in the round pupil group. Cranial magnetic resonance imaging revealed no abnormalities in the oval pupil group. From these results, a peripheral autonomic disorder was implicated in the etiology of oval pupils in diabetic patients.
通过红外摄影测定暗适应瞳孔面积（DAPA）发现，一些糖尿病患者除了DAPA较小外，还存在瞳孔异常，如椭圆形瞳孔（瞳孔异位）。比较了糖尿病患者和健康受试者中椭圆形瞳孔的患病率及临床细节。还对部分糖尿病患者进行了红外视频瞳孔描记术分析瞳孔光反射。研究了年龄对健康受试者瞳孔长轴与短轴直径比值的影响。健康受试者的该比值为1.04±0.02（平均值±标准差），该比值高于平均值+2标准差的病例被定义为椭圆形瞳孔。86例糖尿病患者中有21例（24%）观察到椭圆形瞳孔，且其与代表自主神经功能障碍的心率变异性（P<0.05）和DAPA（P<0.01）相关。红外视频瞳孔描记术对瞳孔光反射的定量分析显示，椭圆形瞳孔组光刺激前的暗适应瞳孔面积（P<0.01）和最大收缩速度百分比（P<0.05）明显小于圆形瞳孔组。头颅磁共振成像显示椭圆形瞳孔组无异常。根据这些结果，提示外周自主神经紊乱与糖尿病患者椭圆形瞳孔的病因有关。
