The Post-Illumination Pupil Response Is Reduced in Glaucoma Patients
The Post-Illumination Pupil Response Is Reduced in Glaucoma Patients
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DOI：
10.1167/iovs.10-6023
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发表时间：
2011-04-01
影响因子：
4.4
通讯作者：
Gamlin, Paul D.
中科院分区：
文献类型：
--
作者：
Kankipati, Laxmikanth;Girkin, Christopher A.;Gamlin, Paul D.
目的。光照后瞳孔反应（PIPR）是由含有黑视素的内在反应驱动的，具有内在光敏性的视网膜神经节细胞，以前在健康眼睛中被表征。本研究比较了青光眼患者的PIPR是否受到影响。16名青光眼患者（平均年龄63.7岁）在扩张后向一只眼睛提供60度，10秒的光刺激（13对数量子/cm(2)/s视网膜辐照度），分别为470 nm（蓝色）或623 nm（红色）。在光偏移后50秒，用红外瞳孔测量法记录未扩张眼的瞳孔一致反应。将这些瞳孔反应与19名年龄匹配的对照组（平均年龄59岁）进行比较。青光眼患者的净PIPR（蓝色PIPR减去红色PIPR）明显小于同龄对照组（1.3 mm, SEM 0.16, P < 0.001） （t检验，P < 0.001） （0.6 mm, SEM 0.12, P < 0.05）。对于患者群体，净PIPR的大小与被测眼睛的视野损失（平均偏差）呈负相关。本研究表明，青光眼患者中iprgc介导的PIPR与年龄匹配的对照组相比显著降低。随着青光眼神经病变严重程度的增加，PIPR也相应降低。因此，该测试有潜力作为评估青光眼患者的临床工具。（Invest Ophthalmol Vis Sci. 2011;52:2287-2292） DOI: 10.1167/iovs.10-6023
PURPOSE. The post-illumination pupil response (PIPR), which is driven by the intrinsic response of melanopsin-containing, intrinsically photosensitive retinal ganglion cells, has previously been characterized in healthy eyes. The present study examined whether the PIPR is affected in patients with glaucoma compared with healthy subjects.METHODS. Sixteen glaucoma patients (mean age, 63.7 years) were tested by presenting a 60 degrees, 10-second light stimulus (13 log quanta/cm(2)/s retinal irradiance) of either 470 nm (blue) or 623 nm (red) to one eye after dilation. The consensual pupil response of the fellow undilated eye was recorded by infrared pupillometry for 50 seconds after light offset. These pupillary responses were compared with those of 19 age-matched controls (mean age, 59 years).RESULTS. The glaucoma patients displayed a net PIPR (blue PIPR minus red PIPR) that was significantly (t-test, P < 0.001) smaller (0.6 mm, SEM 0.12; P < 0.05) than in age-matched controls (1.3 mm, SEM 0.16; P < 0.001). For the patient population, the magnitude of the net PIPR was inversely correlated with the measured visual field loss (mean deviation) of the tested eye.CONCLUSIONS. This study demonstrates that there is a significant decrease in the ipRGC-mediated PIPR in glaucomatous patients when compared to age-matched controls. As the severity of the glaucomatous neuropathy increases, there is a correlated decrease in the PIPR. Therefore, this test has the potential for use as a clinical tool in evaluating patients with glaucoma. (Invest Ophthalmol Vis Sci. 2011;52:2287-2292) DOI: 10.1167/iovs.10-6023