重症肌無力的瞳孔反應與調視機能

Pupillary Response and Accommodative Function in Myasthenia Gravis

10.30048/ACTASOS.198705.0103

呂忠苓(Chung-Lin Lue)；翁林仲(Li-Chung Woung)；柯良時(Liang-Shi Ko)

myasthenia gravis ； pupil cycle time ； accommodation ； anisocoria

台灣眼科醫學會會刊

26卷2期（1987 / 05 / 01）

573 - 579

繁體中文

重症肌無力之病人，其瞳孔反應和調節機能受影嚮之程度，有許多不同的研究及說法。過去大部份研究者認為肌無力患者其瞳孔反應和心肌是正常的。 本文報告肌無力患者41名，分別以細隙燈測試其瞳孔收縮放鬆週期(pupil cycle time)；以自計眼睛疲勞計(Accommodo-polyrecorder)測試眼睛調節能力；並以白動視野計(octopus 200R)測量瞳孔大小。結果顯示：瞳孔收放週期平均為15455msec，較正常值913msec延長甚多；調節機能方面，收縮時間平均3.61sec；（正常1.34sec），鬆弛時間3.41sec；（正常1.2sec），也有明顯失調現象。瞳孔大小檢查則發現1位不等大瞳孔，兩眼差1.5mm。

There had many theories about the dysfunctions of pupil cycle time and accommodative power in myasthenia gravis. This paper presents 41 patients with myathenia gravis. The constriction-dilation cycles of pupils exposed to a stationary, discrete slit-lamp beam were significantly prolonged in 7 1 affected eyes (1599.3 msec) undergoing therapies with steroids, anticholinesterase or none, compared to non- affected eyes (1198.2 msec). But the type of therapy, clinical remission and duration of disease had no statistically significant. The application of H.S. accommodopolyrecorder to 66 eyes. The average contraction time was 3.61 sec, relaxation time was 3.41 sec, compared to normal data, all seemed delayed. (1.34 sec& 1.2sec). Only pupil size differance was in normal range. These results suggested that smooth muscle and autonomic nervous system were all involved in myasthenia gravis. But the real pathogenesis need further investigations.