瞳孔直徑變化對視野檢查的影響

The Effect of Pupillary Diameter on Visual Field Examination

翁林仲(Lin-Chung Woung) ； 吳秋陽(Cheu-Young Wu) ； 洪伯廷(Por-Ting Hung) ； 何良時(Liang-Shi Ko)

《中華民國眼科醫學會會刊》 28卷1期 (1989/05) Pp. 204-208

https://doi.org/10.30048/ACTASOS.198905.0038

摘要

本實驗取二十位健康志願者之四十隻眼睛做縮瞳、散瞳後視野檢查，與正常狀態下之視野做比較。散瞳劑採用Mydrin-P(Tropicamide+phenylephrine)，縮瞳劑採用2% pilocarpine。視野測量用Goldmann-940，以Ⅰ-1e、Ⅰ-2e、Ⅰ-3e、Ⅰ-4e、Ⅴ-4e五種靶點測得。為了解點藥後眼睛之變化及正確矯正其屈調變化，本實驗在點藥前後均測其瞳孔大小、眼壓、屈光變化以資比較。實驗結果顯示點用2%的pilocarpine後瞳孔直徑平均1.6mm，眼壓平均降低1.1mmHg，而屈調變化平均改變負1.1屈光度。點用Mydrin-P後，瞳孔直徑平均8.2mm，眼壓平均降低0.05mmHg，屈調變化為正0.72屈光度。縮瞳後五種光點視野均變小。散瞳後視野Ⅰ-1e, Ⅰ-2e變小，Ⅰ-3e、Ⅰ-4e、Ⅴ-4e則變大。

並列摘要

Twenty Normal subjects, ranging in age from 20-46y/o were studied. Baseline refraction, pupillary diameter, visual acuity and visual field were examined. Visual Field were performed in both eyes with Goldmann Perimeter 940, under test objects 1-1e, I-2e, I-3e, I-4e and V-4e.
We carried out above examination in 40 eyes of 20 Volunteers before and after the instillation of mydriatics (Tropicamide and phenylephrine) and miotics (pilocarpine), in three seperate days. The interval between two examinations at least more than one day.
Average diameter of the pupil was 3.5mm before instillation. 8.2mm after mydriatics and 1.6mm after miotics respectively. After miosis, kinetic perimetry showed significant generalized depression, after mydriasis, Ⅰ-1e, Ⅰ-2e; sopters constricted significantly, while Ⅰ-3e, Ⅰ-4e, Ⅴ-4e isopters enlarged.
We should pay more attention to the pupillary size on interpreting the visual field change to avoid misjudging the results due to unexpectedly dilated or constricted pupil.

並列關鍵字

Visual field ； pupil diameter ； Goldmann 940 Perimeter