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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 investigate pupil light reflex characteristics of patients with posterior optic neuritis (RON) and to investigate the clinical value of pupil light reflex examination in the diagnosis and treatment of RON. Methods The pupil of 35 eyes of 35 clinically diagnosed patients with RON before and after the onset of disease was examined by the pupil tester. Patient age ranged from 10 to 58 years, with an average age of 30.4 years. There was no difference between the control group and the patient group in age and sex. The parameters of light reflection examined include pupil area, maximum response amplitude of pupil to light reflex, latency and maximal response speed. Results At the onset of RON, the response latency of the pupil to the light reflex was prolonged and the maximum response amplitude was decreased. The difference was statistically significant compared with the normal control group. After treatment, with the improvement of the disease, visual acuity recovery, the response latency and the maximum response amplitude of the eye pupil to the light reflex gradually recovered, with statistical significance compared with the onset stage, but there was still significant difference compared with the normal control group. After the onset of eye disease and after treatment, contralateral pupil also showed the reaction latency and maximum response amplitude decreased, but compared with the control group, the difference was not statistically significant. Conclusions The pupil of RON prolongs the latency of light reflex response and decreases the maximum response amplitude. Pupil light reflex examination helps to make an early diagnosis of RON and monitor changes in their condition.