Development of evaluation methods for pathophysiology of ocular visual and motor system using current imaging technique and eye movement recording system

最近可用的三维快速成像采用稳态采集（3-D FIESTA）提供了良好的组织之间的对比度的大脑，神经和脑脊液，除了表现出高的空间分辨率。我们在各种视神经疾病中测试FIESTA，以检查眶内视神经复合体的特征性变化。视神经炎急性期的影像学表现为视神经肿胀伴反应性蛛网膜下腔扩大。视神经束膜炎视神经直径正常，但周围有炎症。视神经萎缩（包括青光眼）的图像显示蛛网膜下腔扩大，视神经鞘周长正常，视神经变薄，而节段性视神经发育不全，视神经鞘周长较小，无蛛网膜下腔扩大。FIESTA序列似乎是一种有用的技术，以区分视神经病变，通过可视化的详细结构的视神经复合体的冠状图像的轨道。其次，在眼球运动和瞳孔研究中，我们使用视频图像分析系统，用红外线CCD摄像机拍摄受试者或患者的每只眼睛，并记录在数字磁带上。使用计算机辅助程序检测瞳孔面积、瞳孔中心和虹膜图案，由此计算水平和垂直眼球运动、瞳孔反应和眼球扭转。记录不同条件下的视乳头近反射和近反射时的眼球扭转。该系统还可用于临床记录眼球震颤、Adie综合征的紧张性乳头反应、会聚麻痹和痉挛，并发现了聚散和瞳孔异常的特征方面。

Recently available three-dimensional fast imaging employing steady-state acquisition (3-D FIESTA) has provided excellent tissue contrast between the brain, nerve and cerebrospinal fluid, in addition to exhibiting high spatial resolution. We tested FIESTA in various optic nerve diseases in order to examine characteristic changes in the intraorbital optic nerve complex. Images of the acute phase of optic neuritis showed swelling of the optic nerve with reactive subarachnoidal space enlargement. In the optic perineuritis, the optic nerve diameter was normal but with surrounding inflammation. Images of optic atrophy including glaucoma showed subarachnoidal space enlargement with normal optic sheath circumference and a thinner optic nerve, while segmental optic nerve hypoplasia appeared with a smaller optic nerve sheath circumference without subarachnoidal space enlargement. The FIESTA sequence seemed to be a useful technique to differentiate optic neuropathies through the visualization of detailed structures of the optic nerve complex on coronal images of the orbit. Next, for eye movement and pupil research, we used video-image analysis system, Subjects' or patients' each eye was photographed with an infra-red CCD camera and recorded on a digital tape. The pupillary area, the center of the pupil, and the pattern of the iris were detected using a computer-assisted procedure, from which horizontal and vertical eye movements, pupillary response, and ocular torsion was calculated. The recorded papillary near reflex and ocular torsion during near response in various conditions. This system is also useful for clinical recording of nystagmus, tonic papillary response in Adie syndrome, convergence palsy and spasm, and characteristic aspects of vergence and pupil abnormalities were found.