CLINICAL GRADING OF RELATIVE AFFERENT PUPILLARY DEFECTS
CLINICAL GRADING OF RELATIVE AFFERENT PUPILLARY DEFECTS
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DOI：
10.1001/archopht.1993.01090070056019
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发表时间：
1993-07-01
影响因子：
--
通讯作者：
YEE, CE
中科院分区：
文献类型：
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作者：
BELL, RA;WAGGONER, PM;YEE, CE
目的：评价采用3秒暂停技术的摆动手电筒测试定量瞳孔相对传入缺陷的有效性和再现性，并将该评分系统与中性密度滤光片评分系统进行比较。设计：我们采用每只眼睛标准照明时间为3秒（暂停时间）的摆动手电筒试验，前瞻性地研究了瞳孔相对传入缺陷患者。每个相对传入瞳孔缺损的分级如下：I级，初始收缩弱，再扩张较大；II级，初期失速和更大的再扩张；III级，瞳孔立即扩张；IV级，正常眼长时间照明6秒后瞳孔立即扩张；V级，瞳孔立即扩张，无继发收缩。将居民个人评价与群体评价进行比较，并将评分体系与中性密度过滤器评分体系进行比较。单位：城市教学医院神经眼科。研究对象：共119例患者。结果：各年级住院医师个人评价与团体评价均有良好的相关性，一致性达78%。五个等级在中性密度过滤对数单位中有相应的值：一级为0.4；二级，0.7；三级，1.1分；四级2.0；V级是无穷大。结论：摆动闪光灯试验3秒暂停技术是检测和定量瞳孔相对传入缺陷的可靠方法。该分级系统可与中性密度过滤器分级系统进行比较，每个等级都有对应的log单位值。
Objectives: To assess the validity and reproducibility of quantitating relative afferent pupillary defects with the swinging flashlight test, using a 3-second pause technique, and to compare this grading system with that using neutral density filters.Design: We prospectively studied patients with relative afferent pupillary defects by using the swinging flashlight test with a standardized illumination time of 3 seconds (pause time) for each eye. Each relative afferent pupillary defect was graded as follows: grade I, a weak initial constriction and greater redilatation; grade II, initial stall and greater redilatation; grade III, immediate pupillary dilatation; grade IV, immediate pupillary dilatation following prolonged illumination of the good eye for 6 seconds; grade V, immediate pupillary dilatation with no secondary constriction. The grades on the individual resident evaluations were compared with those on the group evaluations, and the grading system was compared with the neutral density filter grading system.Setting: Neuro-ophthalmology service of an urban teaching hospital.Study Participants: A total of 119 patients.Results: There was a good correlation in all grades between individual resident and group evaluations, with an overall 78% agreement. The five grades had corresponding values in neutral density filter log units: grade I, 0.4; grade II, 0.7; grade III, 1.1; grade IV, 2.0; and grade V, infinity.Conclusions: The 3-second pause technique for the swinging flashlight test is a reliable method for the detection and quantitation of relative afferent pupillary defects. The grading system can be compared with the neutral density filter grading system, and each grade has a corresponding value in log units.