Chromatic Pupil Responses Preferential Activation of the Melanopsin-mediated versus Outer Photoreceptor-mediated Pupil Light Reflex
Chromatic Pupil Responses Preferential Activation of the Melanopsin-mediated versus Outer Photoreceptor-mediated Pupil Light Reflex
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DOI：
10.1016/j.ophtha.2009.02.007
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发表时间：
2009-08-01
期刊：
影响因子：
13.7
通讯作者：
Kawasaki, Aki
中科院分区：
文献类型：
--
作者：
Kardon, Randy;Anderson, Susan C.;Kawasaki, Aki
目的：视网膜神经节细胞的视杆细胞、视锥细胞和黑视素介导的激活通过改变光刺激的波长、强度和持续时间来驱动瞳孔光反射。设计：实验研究。参与者：43名正常眼和3名神经视网膜视力丧失患者。方法：开发了一种新的刺激范例，使用长波长（红色）或短波长（蓝色）光作为连续的Ganzfeld刺激，在2个对数单位范围内逐步增加。用红外照明摄像机真实的记录光刺激前、光刺激中和光刺激后的瞳孔运动。对低浓度的光刺激，短暂和持续的瞳孔反应的瞳孔收缩百分比是计算每个受试者1只眼睛的中等强度（10 cd/m2）和高强度（100 cd/m2）红光和蓝光刺激。从43个正常的眼睛，中位数和第25，第75，第5，和第95百分位数的值，获得每个刺激condition.Results：在正常的眼睛在较低的强度，蓝光诱发更大的瞳孔反应相比，红光匹配明视亮度。短暂的瞳孔收缩通常大于持续的收缩，这种差异在最低光强度下最大，在明亮的蓝光（100 cd/m2）下最不明显。一位主要视杆细胞功能障碍的患者（不可记录的暗视视网膜电图）在较低强度下对蓝光的瞳孔反应显着降低。一个色盲和一个几乎正常的视野的病人表现出选择性减少的瞳孔反应红光刺激。由于前部缺血性视神经病变的神经节细胞功能障碍的患者表现出全球性的损失，瞳孔反应的红色和蓝色的光在受影响eye.Conclusions：瞳孔反应，不同的光强度和波长的函数支持的假设，选择的刺激条件下可以产生瞳孔反应，反映光转导主要由杆，锥，或黑视蛋白介导。使用彩色瞳孔反应可能是一种新的方法来诊断和监测影响外部或内部retina.Financial披露（S）的疾病：作者没有专有或商业利益，在本文中讨论的任何材料。Ophthalmology 2009;116：1564-1573（C）2009，美国眼科学会。
Objective: To weight the rod-, cone-, and melanopsin-mediated activation of the retinal ganglion cells, which drive the pupil light reflex by varying the light stimulus wavelength, intensity, and duration.Design: Experimental study.Participants: Forty-three subjects with normal eyes and 3 patients with neuroretinal visual loss.Methods: A novel stimulus paradigm was developed using either a long wavelength (red) or short wavelength (blue) light given as a continuous Ganzfeld stimulus with stepwise increases over a 2 log-unit range. The pupillary movement before, during, and after the light stimulus was recorded in real time with an infrared illuminated video camera.Main Outcome Measures: The percent pupil contraction of the transient and sustained pupil response to a low- (1 cd/m(2)), medium- (10 cd/m(2)), and high-intensity (100 cd/m(2)) red- and blue-light stimulus was calculated for 1 eye of each subject. From the 43 normal eyes, median and 25th, 75th, 5th, and 95th percentile values were obtained for each stimulus condition.Results: In normal eyes at lower intensities, blue light evoked much greater pupil responses compared with red light when matched for photopic luminance. The transient pupil contraction was generally greater than the sustained contraction, and this disparity was greatest at the lowest light intensity and least apparent with bright (100 cd/m(2)) blue light. A patient with primarily rod dysfunction (nonrecordable scotopic electroretinogram) showed significantly reduced pupil responses to blue light at lower intensities. A patient with achromatopsia and an almost normal visual field showed selective reduction of the pupil response to red-light stimulation. A patient with ganglion cell dysfunction owing to anterior ischemic optic neuropathy demonstrated global loss of pupil responses to red and blue light in the affected eye.Conclusions: Pupil responses that differ as a function of light intensity and wavelength support the hypothesis that selected stimulus conditions can produce pupil responses that reflect phototransduction primarily mediated by rods, cones, or melanopsin. Use of chromatic pupil responses may be a novel way to diagnose and monitor diseases affecting either the outer or inner retina.Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Ophthalmology 2009;116:1564-1573 (C) 2009 by the American Academy of Ophthalmology.