Abstract
Iris autonomic function was studied by binocular infrared pupillometry in 12 patients with acute primary angle closure glaucoma (APACG) and 28 control subjects. Light reflex amplitude and resting darkness pupil diameter were reduced and miotic response to pilocarpine 0.125% drops increased in APACG when compared to controls with anterior chamber depths (ACD) greater than 2.5 mm but not when compared to controls with ACD of 2.5 mm or less. These findings suggest relative autonomic dysfunction, predominantly parasympathetic, in the anterior segment of the eye in APACG.
Correlation between results of pupil tests and ACD suggested reduced autonomic function in eyes with shallow anterior chambers. Iris autonomic dysfunction in patients with APACG appears to be a reflection of shallow anterior chambers rather than a specific feature of the condition.
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References
Duke-Elder S and Jay B : Diseases of the lens and vitreous, glaucoma and hypotony. In Duke-Elder S ed. System of Ophthalmology, London, Henry Kimpton 1969; Volume XI: 569–71.
Barkan O : Glaucoma: classification, causes and surgical control. Am J Ophthalmol 1938; 21: 1099–117.
Duke-Elder S and Jay B : Diseases of the lens and vitreous, glaucoma and hypotony. In Duke-Elder S ed. System of Ophthalmology, London Henry Kimpton 1969; Volume XI: 573.
Simmons RJ and Dallow RL : Primary angle closure glaucoma. In Duane TD ed. Clinical Ophthalmology. Hagerstown, Harper and Row 1978; chapter 5.
Lowe RF : Acute angle-closure glaucoma precipitated by miotic plus adrenalime eye-drops. Med J Aust 1966; 2: 1037–9.
Clark CV and Mapstone R : Autonomic neuropathy in closed angle glaucoma. Research and Clinical Forums 1985; 7: 45–50.
Mapstone R : Autonomic effects on aqueous outflow. Research and Clinical Forums 1981; 3: 35–9.
Törnquist R : Chamber depth in primary acute glaucoma. Br J Ophthalmol 1956; 40: 421–9.
Fison PN, Garlick OJ, Smith SE : Assessment of unilateral afferent pupillary defects by pupillography. Br J Ophthalmol 1979; 63: 195–9.
Smith SA, Smith SE, Lazare R : An increased effect of pilocarpine on the pupil by application of the drug in oil. Br J Ophthalmol 1978; 62: 314–7.
Lowenstein O and Loewenfeld IE : Role of sympathetic and parasympathetic systems in reflex dilatation of the pupil. Arch Neural Psychiatr 1950; 64: 3l3–40.
Bourgon P and Thompson HS : How to test for cholinergic supersensitivity of the iris sphincter. In Thompson HS, Daroff R et al., eds. Topics in Neuro-Ophthalmology. Baltimore: Williams and Watkins 1979: 115–9.
Armstrong JR, Daily RK, Dobson HL, Girard LJ : The incidence of glaucoma in diabetes mellitus. Am J Ophthalmol 1960; 50: 55–68.
Nielsen NV : The prevalence of glaucoma and ocular hypertension in type 1 and 2 diabetes mellitus. Acta Ophthalmol 1983; 61: 662–72.
Mapstone R and Clark CV : Prevalence of diabetes in glaucoma. Br Med J 1985; 291: 93–5.
Smith SE, Smith SA, Brown PM, Fox C, Sönksen PH : Pupillary signs in diabetic autonomic neuropathy. Br Med J 1978; 2: 924–7.
Smith SA and Smith SE : Reduced pupillary light reflexes in diabetic autonomic neuropathy. Diabetologia 1983; 24: 330–2.
Diabetes Mellitus. Technical Report Series 727. Geneva: World Health Organisation 1985.
Lowenstein O and Loewenfeld IE : Mutual role of sympathetic and parasympathetic in shaping the pupillary reflex to light. Arch Neural Psychiatr 1950; 64: 341–77.
Smith SA : Pupillary function in autonomic failure. In Bannister R ed. Autonomic Failure. Oxford University Press 1988: 40l.
Clark CV and Mapstone R : Pupil cycle time in primary closed-angle glaucoma. Can J Ophthalmol 1986; 21: 88–9l.
Thompson HS : The pupil cycle time. J Clin Neuro-ophthalmol 1987; 7: 38–9.
Martyn CN and Ewing DJ : Pupil cycle time: a simple way of measuring an autonomic reflex. J Neural Neurasurg Psychiatr 1986; 49: 771–4.
Blumen SC, Feiler-Ofry V, Korczyn AD : The pupil cycle time in Horner's syndrome. J Clin Neuro-Ophthalmol 1986; 6: 232–5.
Smith SE and Smith SA : Heart rate variability in healthy subjects measured with a bedside computer-based technique. Clin Sci 1981; 61: 379–83.
Bourne P, Smith SA, Smith SE : Dynamics of the light reflex and the influence of age on the human pupil measured by television pupillometry. J Physiol 1979; 293: 58P
Smith SA and Smith SE : Evidence for a neuropathic aetiology in the small pupil of diabetes mellitus. Br J Ophthalmol 1981; 67: 89–93.
Duke-Elder S and Abrams O : Ophthalmic optics and refraction. In Duke-Elder S ed. System of Ophthalmology. London: Henry Kimpton 1970; Volume V: 161–2.
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Brazier, D. Iris autonomic function in acute glaucoma. Eye 3, 288–293 (1989). https://doi.org/10.1038/eye.1989.40
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DOI: https://doi.org/10.1038/eye.1989.40
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