Yamazaki A, Ishikawa S
Br J Ophthalmol. 1976 Aug;60(8):575-80. doi: 10.1136/bjo.60.8.575.
Using an open-loop stimulus (Maxwellian view), the direct pupillary response to light and its derivative curves (velocity and accleration of pupillary reactions) were recorded by infrared video pupillography in seven patients with myasthenia gravis and in three normal subjects. Responses before and after intravenous injection of 5 mg edrophonium hydrochloride were determined. Five of the patients had never taken anticholinesterase drugs except for diagnostic injections of edrophonium while the other two patients had been treated with oral preparations of corticosteroids. Analyses of the pupillary responses showed reduced amplitude, amximal velocity, and maximal acceleration of pupillary constriction in the myasthenic patients. On the other hand, changes in parameters of pupillary dilatation were minimal. Abnormal values returned towards normal within five minutes after edrophonium injection in all patients except in one individual who was being treated with corticosteroids at the time of examination. These results suggest that involvement of the iris sphincter may be common in patients with myasthenia gravis and this can be demonstrated by analysing the pupillary reaction and its derivative curves in response to an open-loop stimulus.
采用开环刺激（麦克斯韦视野），通过红外视频瞳孔描记法记录了7例重症肌无力患者和3名正常受试者对光的直接瞳孔反应及其导数曲线（瞳孔反应的速度和加速度）。测定了静脉注射5mg盐酸依酚氯铵前后的反应。5例患者除了用于诊断的依酚氯铵注射外，从未服用过抗胆碱酯酶药物，而另外2例患者曾接受过皮质类固醇口服制剂治疗。瞳孔反应分析显示，重症肌无力患者瞳孔收缩的幅度、最大速度和最大加速度降低。另一方面，瞳孔扩张参数的变化很小。除1例在检查时正在接受皮质类固醇治疗的患者外，所有患者在注射依酚氯铵后5分钟内异常值均恢复正常。这些结果表明，虹膜括约肌受累在重症肌无力患者中可能很常见，这可以通过分析对开环刺激的瞳孔反应及其导数曲线来证明。
