单眼挫伤瞳孔对光反射与视功能改变的相关研究

Correlation Analysis of Pupil Light Reflex and Visual Functions after Unilateral Ocular Contusion

目的:测量单眼挫伤患者瞳孔对光反射的改变,分析瞳孔对光反射与眼挫伤后其他视功能评价方法的相关性。方法:使用红外线自动瞳孔仪分别检测26例单眼挫伤患者双眼瞳孔对光反射,并行视力、视野、图形视觉诱发电位等视功能检查。检查的瞳孔对光反射参数包括瞳孔面积,对光反应潜伏期、反应幅度。结果:眼挫伤患者健眼直接、间接反应幅度比与双眼视力差具有显著相关性(r=-0.648);瞳孔对光反应幅度差、反应幅度比均与视野平均偏差具有显著相关性(r=0.5和r=-0.535);瞳孔对光反应幅度比与双眼视觉诱发电位振幅比具有显著相关性;多重线性回归分析显示瞳孔对光反应幅度和VEP振幅结合可提高预测视力预后的可能性。结论:在瞳孔对光反射各参数中,瞳孔对光反应幅度在反映眼挫伤后视功能改变方面优于其它参数,眼挫伤患者瞳孔对光反应幅度与视力、视野、VEP波幅具有中度相关性,其与VEP联合应用可提高眼挫伤后准确预测视功能的可能性。

Subjects and objective ： To measure the quantitative pupil light reflex after unilateral ocular contusion, analyze the correlation of pupil light reflex and other tests of visual function. Methods ： The pupil light reflex in 26 patients who suffered unilateral ocular contusion was tested by infrared video pupillography, psychophysical and electrophysiological tests including visual acuity, visual field, and visual evoked potentials were also tested. Pupil area, the latency and amplitude of pupil light reflex were recorded. Results ： The correlation of the ratio of pupil light reflex amplitude and the differences of visual acuity between 2 eyes in 26 contusion patients was statistically significant. The correlation coefficient r was -0.648. There were significant correlation between amplitude of pupil light reflex and median defect of visual field. The correlation coefficients r were 0.5 and 0.535. The significant correlations were found in the ratio of amplitudes between pupil light reflex and visual evoked potentials. Multiple linear regression analysis showed combining pupil light reflex amplitude and visual evoked potential amplitude could elevate the possibility of predicting visual acuity. Conclusion： Pupil light reflex amplitude measurement is superior to other pupil measurements for reflection of the changes of visual function after ocular contusion. The correlations of pupil light reflex amplitude and visual acuity, visual field, visual evoked potential are significant in the ocular contusion patient. Pupil light reflex combined with visual evoked potential could elevate the possibility of predicting visual function precisely after ocular contusion. Eye Science 2008 ; 24： 53-57.