Abstract
Infrared television pupillometry was performed on 34 insulin-treated diabetic patients and 55 healthy subjects. Sixteen of the diabetic patients had pupils that failed to dilate normally in darkness. The occurrence of a small pupil was associated with cardiac vagal dysfunction and somatic sensory loss. The small pupil was found to be supersensitive to the mydriatic effect of topical 2% phenylephrine but normally sensitive to 0.5% hydroxyamphetamine eyedrops. It is concluded that the failure of the pupil to dilate in darkness in some diabetic patients is due to neuropathy of the sympathetic innervation.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baron M. D., Shenouda F. S., Sönksen P. H. Micro-column method for HbA1 determination. Lancet. 1980 May 24;1(8178):1114–1116. doi: 10.1016/s0140-6736(80)91557-3. [DOI] [PubMed] [Google Scholar]
- Freschi J. E., Parfitt A. G., Shain W. G. Electrophysiology and pharmacology of striated muscle fibres cultured from dissociated neonatal rat pineal glands. J Physiol. 1979 Aug;293:1–10. doi: 10.1113/jphysiol.1979.sp012875. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fujii T., Ishikawa S., Uga S. Ultrastructure of iris muscles in diabetes mellitus. Ophthalmologica. 1977;174(4):228–239. doi: 10.1159/000308607. [DOI] [PubMed] [Google Scholar]
- Korczyn A. D. Adrenergic denervation supersensitivity. Adv Neurol. 1975;9:113–120. [PubMed] [Google Scholar]
- Korczyn A. D., Laor N., Nemet P. Sympathetic pupillary tone in old age. Arch Ophthalmol. 1976 Nov;94(11):1905–1906. doi: 10.1001/archopht.1976.03910040615006. [DOI] [PubMed] [Google Scholar]
- Low P. A., Walsh J. C., Huang C. Y., McLeod J. G. The sympathetic nervous system in diabetic neuropathy. A clinical and pathological study. Brain. 1975 Sep;98(3):341–356. doi: 10.1093/brain/98.3.341. [DOI] [PubMed] [Google Scholar]
- Maloney W. F., Younge B. R., Moyer N. J. Evaluation of the causes and accuracy of pharmacologic localization in Horner's syndrome. Am J Ophthalmol. 1980 Sep;90(3):394–402. doi: 10.1016/s0002-9394(14)74924-4. [DOI] [PubMed] [Google Scholar]
- Ohrt V. Diabetic iridopathy. Clinical studies of the pigment layer of the iris, pupillary function and rubeosis iridis in diabetic patients. Dan Med Bull. 1968 Oct;15(8):244–248. [PubMed] [Google Scholar]
- Pirart J. Diabète et complications dégénératives présentation d'une étude prospective portant sur 4400 cas observés entre 1947 et 1973. (Première partie). Diabete Metab. 1977 Jun;3(2):97–107. [PubMed] [Google Scholar]
- Smith S. A., Smith S. E., Lazare R. An increased effect of pilocarpine on the pupil by application of the drug in oil. Br J Ophthalmol. 1978 May;62(5):314–317. doi: 10.1136/bjo.62.5.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith S. E., Smith S. A., Brown P. M., Fox C., Sönksen P. H. Pupillary signs in diabetic autonomic neuropathy. Br Med J. 1978 Sep 30;2(6142):924–927. doi: 10.1136/bmj.2.6142.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith S. E., Smith S. A. Heart rate variability in healthy subjects measured with a bedside computer-based technique. Clin Sci (Lond) 1981 Oct;61(4):379–383. doi: 10.1042/cs0610379. [DOI] [PubMed] [Google Scholar]
- Sneddon J. M., Turner P. The interactions of local guanethidine and sympathomimetic amines in the human eye. Arch Ophthalmol. 1969 May;81(5):622–627. doi: 10.1001/archopht.1969.00990010624005. [DOI] [PubMed] [Google Scholar]
- TRENDELENBURG U. Supersensitivity and subsensitivity to sympathomimetic amines. Pharmacol Rev. 1963 Jun;15:225–276. [PubMed] [Google Scholar]
- Thompson H. S. Diagnosing Horner's syndrome. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977 Sep-Oct;83(5):840–842. [PubMed] [Google Scholar]