自主感光视网膜神经节细胞与彩色光瞳孔测量

Intrinsically Photosensitive Retinal Ganglion Cells and Chromatic Pupillometry

自主感光视网膜神经节细胞(ipRGCs)是除视杆细胞、视锥细胞以外的第三类光感受器细胞,位于视网膜内层,由于其内含黑视蛋白,故具备自主感光能力。瞳孔对光反应(PLR)主要由ipRGCs介导产生。ipRGCs可通过黑视蛋白直接感受光信号产生PLR,也可被来自视杆、视锥细胞的信号激活产生PLR。由于视杆细胞、视锥细胞和黑视蛋白产生的PLR各具特点,可采用不同强度和波长的光信号选择性刺激视杆细胞、视锥细胞和黑视蛋白,通过对产生的PLR进行分析可间接反映视杆细胞、视锥细胞和含黑视蛋白的ipRGCs的功能,这一方法称为彩色光瞳孔测量。现主要对ipRGCs介导PLR的通路、视杆/视锥细胞和黑视蛋白引起的PLR特点、彩色光瞳孔测量及其临床应用作一综述,希冀为相关眼科疾病的诊断及鉴别诊断提供新思路。

Independently photosensitive retinal ganglion cells(ipRGCs)are the third type of photoreceptor cells besides cones and rod cells,located in the inner retina.They contain melanopsin and have the unique ability to respond to light directly.Pupilary light reflex(PLR)is mainly mediated by ipRGCs.IpRGCs can generate PLR by directly sensing light signals from melanopsin,and can also be activated by signals from rods and cones.Because different photoreceptors play unique roles in PLR,light signals of different intensities and wavelengths can be used to selectively stimulate rods,cones,and melanopsin.Analysis of the generated PLR can indirectly reflect the functions of rods,cones,and ipRGCs containing melanopsin.This method is called chromatic pupillometry.This article reviews the pathways of ipRGCs-mediated PLR,the characteristics of PLR mediated by rod/cone cells and melanopsin,the measurement of chromatic pupillometry and their clinical applications,hoping to provide new ideas for the diagnosis and differential diagnosis of related ophthalmic diseases.