Leber遗传性视神经病变瞳孔对光反射的观察  

Observation of pupillary light reflex in patients with Leber hereditary optic neuropathy

作　　者：周跃明 童绎 ZHOU Yueming;TONG Yi(Department of Ophthalmology,Fuzhou South east Eye Hospital,Fuzhou 350000,China)

机构地区：[1]福州东南眼科医院,福州350000

出　　处：《中国实用眼科杂志》2018年第4期326-328,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察Leber遗传性视神经病变患者的瞳孔及瞳孔对光反射特征,探讨瞳孔对光反射检查在Leber遗传性视神经病变诊断中的临床应用价值。方法用鹰视Topolyzer.Vario角膜地形图仪的瞳孔测量软件Pupillometer分别检测18例(男16例,女2例)临床确诊的Leber遗传性视神经病变(LDHN)患者36只患眼(11778点突变皆阳性)和正常对照组30例60只眼的暗环境和亮刺激下的瞳孔大小及瞳孔对光反射。患者组年龄8~70岁,平均年龄34.5岁;对照组(男27例,女3例)年龄10~67岁,平均年龄35.1岁。对照组与患者组年龄、性别无差异。检查的瞳孔及瞳孔对光反射参数包括暗环境瞳孔大小、亮环境瞳孔大小,瞳孔对光反射的最大反应幅度。结果LOHN患眼在暗环境和亮刺激下瞳孔大小与对照组相比,其差异有统计学意义。对光反射的最大反应幅度与正常对照组相比差异无统计学意义。结论LOHN患眼瞳孔光反射良好,即便视力很差,瞳孔对光反射仍然存在,但对光反射略迟钝,认为应归因于选择的黑视蛋白(Melanopsin)在视网膜神经节细胞的免于受损。所以,利用鹰视Topolyzer.Vario角膜地形图仪的Pupillometer软件可观察瞳孔的变化。Objective To investigate the characteristics of pupil and pupil light reflex in patients with Leber hereditary optic neuropathy and to investigate the clinical value of pupil light reflex in the diagnosis of Leber hereditary optic neuropathy.Methods Dark and light environment under the stimulation of pupil size and pupillary light reflex were measured with a pupilometer,18 cases of clinically diagnosed Leber hereditary optic neuropathy patients(16 males and 2 females,36 eyes)were detected with 11778 point positive mutations,and 30 cases(60 eyes)were as normal control group.The age of the patients ranged from 8 to 70 years old,with an average age of 34.5 years old.There was no difference in age and gender between the control group and the patient group.Results There were statistical significance between patients groups and normal groups on the pupil and pupil light reflex parameters included the pupil size of the dark environment,the pupil size of the bright environment,and the maximum response amplitude of the pupil to the light reflection.Conclusions LOHN with the pupil light reflex is good,even very poor eyesight,pupillary light reflex still exists,but the light reflection is slightly dull.

关 键 词：Leber/视神经疾病 瞳孔对光反射 

分 类 号：R77[医药卫生—眼科]