Donahue S P, Moore P, Kardon R H
Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8808, USA.
Ophthalmology. 1997 Dec;104(12):2161-7. doi: 10.1016/s0161-6420(97)30046-3.
This study was designed to determine whether the relative afferent pupillary defects observed commonly in amblyopic eyes are associated with a uniform depression of the pupillary light reflex throughout the visual field or solely by a focal decrease in pupillary response near fixation.
The authors used pupil perimetry to evaluate the contraction amplitude of the pupil in response to focal light stimuli at 76 points throughout the 30 degrees field in each eye of 28 patients with amblyopia. The "pupil fields" were recorded using a computerized infrared pupillograph linked to a Humphrey Field Analyzer, so that the pupil contraction could be recorded in response to perimetric light stimuli.
Nine patients had strabismic amblyopia, ten had anisometropia, six had a combination of anisometropia and strabismus, and three had deprivation amblyopia due to monocular congenital cataract.
Mean pupillary contraction amplitude for the entire field and focal amplitudes at each tested location were compared. Mixed-model analysis of variance was used to assess effects of perimetry location, type of amblyopia, and interaction effects.
The overall average of all the pupil contractions throughout the 30 degrees field was less for the amblyopic eye compared with that of the fellow eye. This decrease in focal pupil response for amblyopic eyes was present in each type of amblyopia and was greatest for deprivation amblyopia. The contraction amplitude was depressed diffusely throughout the pupil field and showed neither focal deficits nor a selective depression about fixation.
Amblyopia produces a global depression of focal pupillary responses across the entire 30 degrees field.
本研究旨在确定弱视眼中常见的相对传入性瞳孔缺陷是否与整个视野中瞳孔光反射的均匀减弱相关，还是仅与注视点附近瞳孔反应的局部降低有关。
作者使用瞳孔视野计评估了28例弱视患者每只眼睛在30度视野内76个点上对局部光刺激的瞳孔收缩幅度。使用与Humphrey视野分析仪相连的计算机化红外瞳孔描记仪记录“瞳孔视野”，以便记录瞳孔对视野计光刺激的收缩情况。
9例患者为斜视性弱视，10例为屈光参差性弱视，6例为屈光参差合并斜视，3例为单眼先天性白内障所致的剥夺性弱视。
比较整个视野的平均瞳孔收缩幅度和每个测试位置的局部幅度。采用混合模型方差分析评估视野计位置、弱视类型及交互作用的影响。
与健眼相比，弱视眼在整个30度视野内所有瞳孔收缩的总体平均值较低。弱视眼的局部瞳孔反应降低在每种类型的弱视中均存在，且在剥夺性弱视中最为明显。收缩幅度在整个瞳孔视野中呈弥漫性降低，既无局部缺陷，也无关于注视点的选择性降低。
弱视会导致整个30度视野内局部瞳孔反应的整体降低。
