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KMID : 0882419930440020256
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Korean Journal of Medicine
1993 Volume.44 No. 2 p.256 ~ p.262
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The Pupillary Response to Light in Diabetic Autonomic Neuropathy
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Abstract
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bnormalities of the pupil of the eye are well known in long-term diabetes and it is well
known that changes in the autonomic nervous system can be reflected in the pupil.
To investigate the abnormalities of the pupil in diabetics, the pupillary response to light
was examined by pupillometry and persistent regular oscillations of the pupil were measured
by slit lamp in 44 healthy and 127 diabetic subjects.
The diabetic patients had a smaller initial, minimal, and final pupil size and a smaller
response amplitude than the control subjects. The maximal velocities of constriction and
re-dilatation were reduced in the diabetic patients. An abnormally prolonged dilatation phase
(time of maximum redilation velocity) was observed. Pupil cycle time was prolonged in a
high proportion of patients with evidence of autonomic neuropathy judged by abnormalities of
their cardiovascular reflexes. There was significant correlation between results of
cardiovascular and pupillary autonomic function tests.
In conclustion, Measurement of the pupillary response in darkness was a simple,
noninvasive and reproducible method that may yield information about autonomic nervous
involvement in diabetics and may be a useful complement to cardiovascular testing in clinical
diagnosis of autonomic neuropathy.
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