球后视神经炎患者的瞳孔对光反射特征

Characteristics of the pupillary light reflex in the patients with retrobulbar neuritis

目的了解球后视神经炎（RON）患者的瞳孔对光反射特征，探讨瞳孔对光反射检查在RON诊断和治疗中的临床应用价值。方法用瞳孔测试仪分别检测35例临床确诊的RON患者35只患眼治疗前（发病期）后、对侧眼以及正常对照组50例100只眼的瞳孔对光反射。患者组年龄10～58岁，平均年龄30．4岁；对照组与患者组年龄、性别无差异。检查的对光反射参数包括瞳孔面积、瞳孔对光反射的最大反应幅度、潜伏期和最大反应速度。结果在RON的发病期，患眼瞳孔对光反射的反应潜伏期延长、最大反应幅度减小，与正常对照组相比差异有非常显著的统计学意义。治疗后，随着病情改善、视力恢复，患眼瞳孔对光反射的反应潜伏期、最大反应幅度等逐渐恢复，与发病期相比差异有统计学意义，但与正常对照组比较仍然有显著差异。患眼发病期和治疗后，对侧眼瞳孔也表现为反应潜伏期和最大反应幅度下降，但与对照组相比，其差异均无统计学意义。结论RON患眼的瞳孔对光反射反应潜伏期延长、最大反应幅度减小。瞳孔对光反射检查有助于对RON做出早期诊断并监测其病情变化。

Objective To observe the characteristics of pupillary light reflex in the patients with retrobulbar neuritis, and to evaluate the effects of pupillary light reflex on the diagnosis and treatment of retrobulbar neuritis. Methods Thirty-five patients （thirty five eyes with the retrobulbar neuritis and thirty-five fellow eyes） aged from 10 to 58 years and 50 healthy individuals （100 eyes） who didn＇t differ from the patients in age and sex were examined by a automatic pupillometer. The pupillary area and response amplitude, latency and speed of papillary reflex were recorded. Results The latency of the pupillary light reflex delayed and the maximum amplitude decreased in patients with retrobulbar neuritis during the diseaseperiod, and the differences were highly significant compaired with the control group. After the treatment, as the symptoms were alleviated and the visual acuity improved, the latency of the pupillary light reflex and the maximum amplitude recovered. The statistic differences were both found between the results after treatment and those at the onset stage, and the results after treatment and those in the control group. Before the onset of the disease of the involued eyes and after the treatment, the papillary light reflex and the maxium amplitude decreased, but didn＇t differe much from which in the control group. Conclusions The latency of the pupillary light reflex delayes and the maximum amplitude decreases in patients with retrobulbar neuritis. The examination of pupillary light reflex is helpful to diagnose retrobulbar neuritis early and inspect the condition of the disease.