糖尿病患者瞳孔动态变化

Pupillary movements of diabetic patients

目的 研究糖尿病患者视网膜病变程度和瞳孔变化的相关性。方法 无视网膜病变者14例 (2 2只眼 ) ,单纯型视网膜病变 14例 (2 2只眼 ) ,增殖前视网膜病变 15例 (2 5只眼 ) ,增殖型视网膜病变 (PDR) 11例 (2 1只眼 )。采用C2 514 型手提式电子瞳孔测定仪 ,测定参数如下 :光刺激前瞳孔直径 (D1)、光刺激后瞳孔最小径 (D2 )、光刺激前瞳孔面积 (A1)、最高缩瞳速度 (Vc)、光刺激开始至缩瞳开始时间 (t1)。结果 D1、D2 、A1仅当视网膜病变存在时出现显著性减少 ;t1处于PDR阶段时 ,与其他组相比有统计学延长 ;Vc在糖尿病性视网膜病变 (DR)前期即出现显著性减少 ,并随着视网膜病变恶化逐渐减低。结论 糖尿病患者瞳孔变化可以反映视网膜病变程度。

Objective Correlation between the stages of diabetic retinopathy(DR)and the pupillary movements of diabetes was investigated. Methods Examined cases included 22 eyes of 14 patients without DR,22 eyes of 14 patients with background retinopathy,25 eyes of 15 patients with preproliferative DR and 21eyes of 11 patients with proliferative DR.Among the parameters of pupillary movements examined by the C 2514 handy iriscorder,diameter of pupil in initial stage(D 1),minimum diameter of pupil after photostimulation(D 2),pupillary area in initial stage(A 1),duration from the photostimulation to the start of miosis(t 1)and maximum miotic speed(Vc)were examined in this study. Results D 1、D 2 and A 1 decreased significantly only in the group with DR.But t 1 in the group with proliferative DR was prolonged significantly.In contrast,Vc decreased significantly at the stage of preproliferative DR,and this abnormality was suspected to occur with the development of diabetic retinopathy. Conclusions Pupillary movements of diabetes can reflect the stages of DR.