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At least 523 records · Page 29Linked to original sources
PubMed2000

Changes in pupil reaction to light in Alzheimer's disease patients: a preliminary report.

The aim of this preliminary study was to compare the pupil reaction to light in Alzheimer's disease (AD) patients before and after treatment and in normal controls. Ten AD patients diagnosed according to DSM-IV and NINCDS-ADRDA criteria (five medication-free and five under anticholinesterase treatment) and five age- and gender-matched controls took part in the study. Drug-free patients and all control subjects were free of any medication for at least four weeks. An optical method was used to assess the pupil reaction to a single flash. Medication-free AD patients manifested shorter latency and lower amplitude of maximum response to light in comparison to controls. These findings are in agreement with the presence of a cholinergic deficit in AD patients. Pharmacological treatment with donepezil, which is an anticholinesterase agent partially improves this deficit. The results of this preliminary investigation suggest that dynamic pupillometry could be a useful adjunct to assist the diagnosis of early AD, and the differential diagnosis between different types of dementia. AD patients seem to manifest a specific pattern of pupil reaction to light, and some characteristics of this pattern are detectable even in patients receiving anticholinesterase medication. However, this is only a preliminary report and further research is mandatory.

Alzheimer Disease↗
PubMed2003

Tropicamide effects on pupil size and pupillary light reflexes in Alzheimer's and Parkinson's disease.

Diagnostic tests for Alzheimer's disease (AD) involving tropicamide blockade of cholinergic oculomotor functions were examined in AD patients (n=15), Parkinson's disease (PD) patients (n=15), and non-clinical control (NC) participants (n=15). Pupillographic methods were used to measure pupil diameter and pupillary light reflexes after double-blind ocular administration of dilute tropicamide (0.01%) in one eye and saline in the other eye. Changes in pupil size were measured in bright background light and near-darkness. Tropicamide increased pupil diameter to a similar extent in all three groups in light and darkness. Tropicamide also reduced the amplitude and latency of the pupillary light reflex to a similar extent for all three groups. Tropicamide pupillary response tests, therefore, were not sensitive or specific diagnostic tests for AD. Peak constriction amplitude of the pupillary light reflex was significantly reduced in both eyes in AD and PD groups relative to non-clinical controls, but AD and PD groups did not differ significantly. The pupillary light reflex test, therefore, was sensitive to AD, but lacked adequate specificity. Finally, peak constriction amplitude correlated significantly with dementia severity and donepezil treatment may have partially normalized pupillary light reflex abnormalities in AD patients. The pupillary light reflex test, therefore, may index central cholinergic dysfunction associated with disease progression and improvement in cholinergic function associated with pharmacologic treatment response in AD.

Aged↗
PubMed2005

[Arteriovenous malformation of the brain revealed through a visual blur and Adie's pupil].

INTRODUCTION: Arteriovenous malformations of the brain (BAVMs) are a relatively rare group involving intracranial vascular lesions (telangiectasia, cavernous malformation, venous anomaly). We report the case of a patient who presented an atypical visual symptomatology revealing a BAVM. OBSERVATION: A 48-year-old woman consulted for a recent bilateral visual blur. In darkness, discrete anisocoria appeared on the left eye. At the biomicroscopy light examination, we found areflexic semi-mydriasis (direct and consensual) on the left eye; the light reflex (direct and consensual) on the right eye was normal. During the accommodative reflex test the left pupil contracted. We propose the diagnosis of Adie's pupil, which was confirmed by the pilocarpine test (0.125%). We decided to examine the visual field because the symptomatology of the visual blur remained unexplained. The visual field showed a left homonymous inferior lateral scotoma. MRI showed a right occipital arteriovenous malformation. DISCUSSION: A quick examination could confuse painless anisocoria with a compression of the IIIrd intrinsic left nerve. This recent scotoma revealed BAVM progression. The natural history of BAVMs shows that the essential risk of these injuries is the onset of an intracranial hemorrhage. To reach a radical therapeutic decision, a cerebral arteriography clarifying the afferent and efferent vascularity of the nidus was carried out. CONCLUSION: This case is original in that it associates the concomitant discovery of a BAVM and Adie's pupil. Symptomatic BAVMs are extremely serious. Planning their treatment requires multidisciplinary cooperation in order to reduce the risk of mortality.

Female↗
PubMed2003

Effect of pupil size on visual function under monocular and binocular conditions in LASIK and non-LASIK patients.

PURPOSE: To compare binocular and monocular vision in patients treated with laser in situ keratomileusis (LASIK) and in non-LASIK patients. SETTING: Jules Stein Eye Institute, Los Angeles, California, USA. METHODS: This comparative cross-sectional study comprised 20 postoperative LASIK patients and 20 non-LASIK ametropic patients. LogMAR visual acuity, contrast sensitivity, and infrared pupillometry were tested. Outcome measures were better-eye monocular acuity, binocular acuity, better-eye contrast sensitivity, binocular contrast sensitivity, and pupil diameter under monocular and binocular conditions. RESULTS: Binocular visual acuity and contrast sensitivity were statistically significantly better than the visual acuity in the better eye (P =.0047 to <.0001) in both patient groups. Pupil diameter was statistically significantly smaller under the binocular condition than the monocular condition (P <.0001) in both groups. CONCLUSIONS: Monocular testing induced larger pupil diameters, which was associated with reduced vision compared to binocular measurements in LASIK and non-LASIK patients.

Adult↗
PubMed1997

Effectiveness of topical diclofenac in relieving photophobia after pupil dilation.

PURPOSE: To test the effectiveness of topical diclofenac in relieving photophobia after pupil dilation. SETTING: Department of Ophthalmology, Newcastle General Hospital, Newcastle-upon-Tyne, United Kingdom. METHODS: Twenty healthy patients and volunteers from the outpatient ophthalmology clinic were enrolled in a prospective, double-blind, placebo-controlled comparison in which the patient's fellow eye served as a control. Photophobia after pupil dilation was tested subjectively using a visual analog scale and a neutralization scale at 30 minute intervals for 2 hours after instillation of topical diclofenac. RESULTS: Both tests show a statistically significant reduction in photophobia in the diclofenac-treated eyes at each time interval (P < or = .05). This difference was also considered clinically relevant. CONCLUSION: Topical diclofenac given at the time of pupil dilation significantly reduced photophobia. The mechanism of action is unknown and requires further evaluation.

Administration, Topical↗
PubMed1999

Comparison of the effectiveness of 4 anti-inflammatory drops in relieving photophobia after pupil dilation.

PURPOSE: To compare the relative effectiveness of diclofenac, flurbiprofen, ketorolac, and prednisolone acetate in relieving photophobia after pupil dilation for fundus examination. SETTING: Eye, Ear, Nose, and Throat Hospital, New Orleans, Louisiana, USA. METHODS: This prospective, blind, placebo-controlled study comprised 105 patients randomly assigned to 1 of 10 treatment groups. Five minutes after instillation of dilating drops, each patient received drops of different test medications in the right and left eyes. Light sensitivity and pupil measurement tests were performed over 2 hours after the pharmacological mydriasis. After photostimulation, patients were asked to rate their photosensitivity on numerical and analog scales and to indicate a filter value required to alleviate right-induced discomfort. Test results were analyzed to detect differences among the pain levels associated with each treatment. RESULTS: There were no significant differences between the placebo and any active treatment drug at any time during the study. CONCLUSION: These findings suggest that mediators other than prostaglandins may have a role in photosensitivity or that increased postmydriatic photosensitivity is a result of higher light levels entering the eye through the dilated pupil.

Adolescent↗
PubMedDate not supplied

Differential effects of ninaC proteins (p132 and p174) on light-activated currents and pupil mechanism in Drosophila photoreceptors.

The Drosophila ninaC locus encodes two retinal specific proteins (p132 and p174) both consisting of a protein kinase joined to a myosin head domain and a C terminal with a calmodulin-binding domain. The role of p132 and p174 was studied via whole-cell recording and through measurements of the pupil mechanism, i.e. the pigment migration in the photoreceptor cells, in the ninaC mutants, P[ninaC delta 132] (p132 absent), P[ninaC delta 174] (p174 absent), and ninaCP235 (null mutant). Voltage-clamped flash responses in P[ninaC delta 174] and ninaCP235 showed delayed response termination. In response to steady light, plateau responses in both P[ninaC delta 174] and ninaCP235 were also large. In both cases the defect was significantly more severe in ninaCP235. Responses in P[ninaC delta 132] were apparently normal. P[ninaC delta 174] and ninaCP235 were also characterized by spontaneous quantum bump-like activity in the dark and by larger and longer light-induced quantum bumps. The turn-off of the pupil mechanism in P[ninaC delta 174] and ninaCP235 was also defective, although in this case the rate of return to baseline in both mutants was more or less the same. In all ninaC mutants, the amplitudes of the pupillary pigment migration were distinctly smaller than that in the wild type. The reduction of the amplitude was largest in P[ninaC delta 174]. The light sensitivity of the pupil mechanism of P[ninaC delta 174] compared to that of wild type was reduced by 1.3 log units. Remarkably, the light sensitivity of P[ninaC delta 132] and ninaCP235 was ca. 0.5 log units higher than that of the wild type. The results suggest that the p174 protein is required for normal termination of the transduction cascade. The diverse phenotypes observed may suggest multiple roles calmodulin distribution for controlling response termination and regulating pigment migration in Drosophila photoreceptors.

Animals↗
PubMed1997

The relationship between pupil diameter and decentration in myopia.

Since optical zone centration is of such importance in refractive surgery, we have studied, with a computer-aided videopupillograph, the problem of identifying it in myopes. The findings of pupil centre shift as a function of pupil diameter and degree of myopia are reported in two groups of myopes (low and medium) and a control group. Results indicate that the amount and direction of decentration vary according to pupil diameter and degree of myopia. No generally valid instructions can be laid down and each case must be treated on its merits.

Adolescent↗
PubMed2000

The effect of pre-operative topical flurbiprofen or diclofenac on pupil dilatation.

PURPOSE: To assess the clinical benefit and relative efficacy of pre-operative diclofenac and flurbiprofen drops in routine cataract surgery. METHODS: Fifty-two patients undergoing extracapsular cataract extraction with lens implantation were randomised in a double-masked study to compare the efficacy of diclofenac, flurbiprofen and placebo drops in maintaining per-operative mydriasis and reducing post-operative inflammation. Balanced salt solution containing adrenaline was used in all patients. Pupil size was measured prior to the corneal section and after the completion of the operation. The degree of pain, redness, flare and cells in the anterior chamber and intraocular pressure were recorded on the day after surgery. The three groups were analysed with respect to change in pupil size, intraocular pressure and degree of inflammation. RESULTS: The change in pupil size was significantly different among the three groups (p = 0.01), there being a smaller decrease in the treatment groups compared with the placebo group and in the diclofenac treatment group compared with the flurbiprofen treatment group. Significantly less post-operative redness was recorded in the diclofenac treatment group compared with the other groups (p = 0.001). No significant difference was found between the groups as regards anterior chamber cells, flare or intraocular pressure change. CONCLUSIONS: Pre-operative diclofenac and flurbiprofen drops are effective in maintaining intraoperative mydriasis. Diclofenac reduces post-operative redness on day 1. These effects are of debatable clinical benefit.

Adult↗
PubMed1988

Pupil responsiveness in cluster headache: a dynamic TV pupillometric evaluation.

In this study the variations in pupil diameter induced by different stimuli (dark-light adaptation, light reflex, electric stimulation of the sural nerve) were investigated in episodic (in the active or remission phases) and in chronic cluster headache (CH) patients. Pupil size monitoring was performed with a monocular, infrared TV pupillometer, and sural nerve stimuli were applied after the pain threshold had been measured as the flexion reflex threshold of the biceps femoris muscle (RIII reflex). The results were compared with those obtained in patients with "peripheral" (third neuron) Horner's syndrome and in healthy sex- and age-matched controls. On the symptomatic side we found an impairment of pupil response to light flashes and nociceptive stimuli; similar findings were sometimes evident on the pain-free side, too. These results substantiate previous observations that in cluster headache a dysfunction of the integrative central nervous system pathways also exists intercritically and mostly bilaterally, involving both autonomic regulation and pain perception mechanisms.

Adult↗
PubMed2005

[Measurement of scotopic pupils comparing green light test and wave-front analyser WASCA].

OBJECTIVE: The aim of this study was to compare the accuracy and the reproducibility of scotopic pupil measurements using 2 different methods. METHODS: Scotopic pupil diameter was measured in 56 eyes of 28 volunteers and the results were compared between the green light test at the slit lamp (Haag-Streit, Switzerland) and the automatic measurements of the wave-front analyser WASCA (Carl-Zeiss-Meditec) by 2 independent examiners. Non-parametric sign test as well as All Pairwise Multiple Comparison Procedures (Student-Newman-Keuls method) were performed for the comparison of means for each individual eye as well as the results of both eyes tested by both examiners. RESULTS: Mean age of the subjects was 34.9 years. The colour of iris was green or blue in 22 cases and brown in 6 cases. REPRODUCIBILITY: For the green light test we found for the first investigator in the right eye a mean pupil diameter of 6.58 mm (SD 0.68). The measurement of the second investigator for the same eye was 6.64 mm (SD 0.61). The left eye values were as follows: 6.36 mm (SD 0.68) and 6.75 mm (SD 0.68). For WASCA we found for the first investigator in the right eye 6.33 mm (SD 0.64) vs. 6.30 mm (SD 0.64) for the second investigator, in the left eye 6.39 mm (SD 0.69) vs. 6.36 mm (SD 0.60). There was a statistically significant difference between the two investigators when the green light test was used (6.47 mm vs. 6.69 mm for both eyes). No difference was found using the WASCA integrated pupillometer (6.35 mm vs. 6.33 mm). There was a significant difference between the means of combined data for both measurement methods: 6.58 mm for the green light test (SD 0.57) vs. 6.34 mm for WASCA (SD 0.62). CONCLUSIONS: The integrated pupillometry of the WASCA analyser showed better reproducibility of measurements than the green light test. The green light test measures a slightly larger diameter (in the mean by 0.25 mm) than WASCA. Because of the fair and clinically sufficient reproducibility as well as virtually non-existing additional costs the green light test can be strongly recommended to referring ophthalmologists and low-volume refractive surgeons.

Adult↗
PubMed1997

Pupil dilation response to tropicamide: a biological test for Alzheimer's disease?

The pupil dilation response to tropicamide has been proposed as a simple test for demonstrating the central cholinergic deficit present in Alzheimer's disease (AD). We examined this response in 20 patients with clinically diagnosed mild probable AD and in 20 unrelated, cognitively intact, age-matched controls. A marked increase in pupil diameter was observed within 30 minutes in both groups. Differences between the groups did not attain statistical significance. The ability of the proposed test to discriminate between AD patients and healthy controls may be influenced by experimental procedures and by the ethnic background of the subjects under study. At present the pupil dilation response to tropicamide cannot be considered a useful diagnostic aid.

Aged↗
PubMed1998

[Holzwig iris retractor and use in narrow pupils].

BACKGROUND: The objective was to develop an easy to handle tool for temporary implantation to dilate narrow pupils. MATERIAL AND METHODS: High molecular PMMA was used to lathe cut a v-shaped device with sides of 6.9 mm length, 0.8 mm height and 0.4 mm width which opens 7.0 mm. Positioning holes of 0.5 mm diameter are located in the caudal ends of the sides. The HIR was used during cataract extraction in 24 patients with mydriatic-resistant pupils, amblyopia or distinctive macula degeneration. RESULTS: In all 26 cases cataract extraction was made easier due to physiologically dilated pupils. The risk of an intraoperative miosis was effectively eliminated. In two cases removal was difficult as the lower tunnel lip interfered with the removal of the HIR. CONCLUSION: In comparison with the commercially available devices, the HIR is the simplest, safest and most physiologic alternative.

Amblyopia↗
PubMed2002

Orbital neural-glial hamartoma associated with a congenital tonic pupil.

Tonic pupils in children are rare, and only a handful of reports exist in the literature. We present the case of an orbital neural-glial hamartoma in an infant with a congenital tonic pupil and no proptosis. We have previously described this association in another child. This new case, the 6-year follow-up from the previous case, and a discussion of tonic pupils are presented.

Hamartoma↗
PubMed2003

Measuring of ocular wavefront aberration in large pupils using OPD-scan.

Wavefront analysis using a scanning slit refractometer (the OPD-Scan) was evaluated in both artificial and human eyes, in comparison with the Hartmann-Shack wavefront sensor (H-S) currently often used. Comparison of different methods and configurations carried out in the artificial eyes yielded basically the same results in moderate refractive error cases. There was a closer match between the RMS (root mean square) wavefront error obtained by OPD-Scan and H-S in the 6 mm pupils than in the 4 mm pupils of the same normal human eyes. Although OPD-Scan employs a different approach in determining aberration, the aberration value is similar to that of H-S, especially in large pupils.

Adult↗
PubMed1990

How display polarity and lighting conditions affect the pupil size of VDT operators.

This study ascertained that CRTs using a positive display polarity (dark characters on bright background) are ergonomically more appropriate for VDT operators than ones using a negative display polarity (bright characters on dark background), using both physiological and psychological indices. Differences of pupil size and subjective evaluation of visual comfort while undertaking visual tasks were examined for six experimental conditions (two CRT display types in three different illuminated levels). Pupil diameter was not affected greatly when working with the positive display for different illumination levels. The positive display also caused smaller differences in pupil diameter when viewing visual targets, namely CRT display, script, and keyboard, for all lighting conditions. The majority of the subjects also appreciated working with the positive CRT display at a regular office illumination level.

Adult↗
PubMed2006

Measurement of pupil reactivity using fast pupillometry.

Analysis of human eye pupil reactivity is a very valuable diagnostic method used mainly for evaluation of the condition of the autonomic nervous system and the visual system. The paper presents an experimental pupillometer built in the Institute of Physics of the Wroclaw University of Technology. The apparatus makes it possible to record and analyze pupillary light reflex and spontaneous changes in the pupil diameter during a session in the dark. The detector system used in the pupillometer allows us to record the pupil diameter at a rate of 90 Hz with a linear accuracy of 0.008 mm. In this paper, the proposed detection method, the principle of operation and calibration of the apparatus and the possibilities of the measurement system are presented.

Adult↗
PubMed1998

The effect of intracameral adrenaline infusion on pupil size, pulse rate, and blood pressure during phacoemulsification.

Pupillary constriction during phacoemulsification (phaco) and irrigation/aspiration (I/A) is found to be the major cause of iris damage, incomplete cortex removal, posterior capsule rupture, vitreous loss and even posterior lens material dislocation. Cataract surgery is performed more easily if mydriasis can be maintained. Irrigation fluid containing adrenaline is thought to be of benefit in this respect. We designed a prospective study assessing the efficacy and safety of using perioperative adrenaline during phacoemulsification, as an adjunct to preoperative topical mydriatics. Forty-two cases were randomized to receive intraocular irrigation fluid with or without 1:1,000,000 adrenaline, as a study or control group. Diameter of the pupil, pulse rate, systolic and diastolic pressure before-phaco, after-phaco-before-I/A and after-I/A were measured. All of the operations were performed by the same surgeon with the same technique. The pupil size after-phaco-before-I/A was 8.00 mm in the study group and 5.96 mm in the control group. The mydriasis maintained during phacoemulsification was significantly greater in the study group, p < 0.00001. The pupil size after-I/A was 8.03 mm in the study group, and 5.54 mm in the control group. The mydriasis maintained during I/A was significantly greater in the study group, p < 0.00001. Pulse rate and blood pressure in patients of the study group, even those with hypertension, showed no significant fluctuation during the surgery. We concluded that intraocular irrigation with 1:1,000,000 adrenaline was a safe and effective way of maintaining mydriasis during cataract surgery.

Blood Pressure↗