Abstract
Ocular autonomic nerve function was assessed in 28 diabetic patients with proliferative retinopathy (PDR) and 61 age- and sex-matched control subjects, by measurement of the pupil cycle time and determination of autonomic denervation hypersensitivity of the iris. Sustained pupil cycle time was absent in 88.5 per cent of PDR compared with 9.8 per cent of control subjects (p<0.001). Pupil constriction in response to 2.5 per cent methacholine—indicative of parasympathetic denervation hypersensitivity—was significantly increased in PDR (p<0.001), whilst pupil dilation in response to 0.5 per cent phenylephrine—indicative of sympathetic denervation hypersensitivity—was also significantly higher in PDR (p<0.001). Pupil reflexes were abnormal in 88.5 per cent of diabetics with proliferative retinopathy, with established autonomic denervation hypersensitivity in 57 per cent of patients.
Similar content being viewed by others
Article PDF
References
Cannon WB and Rosenbluth A : The supersensitivity of denervated structures: a law of denervation. New York: Macmillan, 1949.
Scheie HG : Site of disturbance in Adie's syndrome. Arch Ophthalmol 1940, 24: 225–37.
Scheie HG and Adler FH : Site of disturbance of tonic pupils (Adie's syndrome). Arch Ophthalmol 1940, 24: 1041–4.
Thompson HS and Mensher JH : Adrenergic mydriasis in Horner's syndrome. Am J Ophthalmol 1971, 72: 472–80.
Smith SA : Horner's syndrome in diabetes mellitus. Diabetic Medicine (in press).
Jaffe NS : Localisation of lesions causing Horner's syndrome. Arch Ophthalmol 1950, 44: 710–28.
Miller SD and Thompson HS : Edge-light pupil cycle time. Br J Ophthalmol 1978, 62: 495–500.
Gabriel R : Time to scrap creatinine clearance? Br Med J 1986, 293: 1119–20.
Baron MD, Shenouda FS, Sonksen PH : Micro column method for HbA1 determination. Lancet 1980, i: 1114–16.
Clark CV and Mapstone R : Parasympathetic denervation hypersensitivity of the iris in ocular hypertension. Invest Ophthalmol Vis Sci (in press).
Nie NH : A complete guide to SPSSx language and operations. New York: McGraw Hill, 1983.
Martyn CN and Ewing DJ : Pupil cycle time: a simple way of measuring an autonomic reflex. J Neurol Neurosurg Psychiatry 1986, 49: 771–4.
U'Pritchard DC, Bechtel WD, Roust BM, Snyder SH : Multiple apparent alpha-noradrenergic binding sites in rat brain: effect of 6-hydrox- ydopamine. Molec Pharmacol 1979, 16: 47–60.
U'Pritchard DC and Snyder SH : Increase in alpha-receptor number in reserpine sensitivity in rats. Eur J Pharmacol 1978, 51: 145–55.
Turner P : The human eye as a target to analyse the mechanism of action of substances. Sandoz J Med Sci 1969, 3: 91–7.
Clark CV : Autonomic neuropathy in proliferative diabetic retinopathy. Eye (in press).
Smith SE, Smith SA, Brown PM : Cardiac autonomic dysfunction in patients with diabetic retinopathy. Diabetologia 1981, 21: 525–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Clark, C. Ocular autonomic nerve function in proliferative diabetic retinopathy. Eye 2, 96–101 (1988). https://doi.org/10.1038/eye.1988.20
Issue Date:
DOI: https://doi.org/10.1038/eye.1988.20
This article is cited by
-
The effectiveness of automatic pupillometry as a screening method to detect diabetic autonomic neuropathy
International Ophthalmology (2020)
-
Pupillary Abnormalities with Varying Severity of Diabetic Retinopathy
Scientific Reports (2018)
-
Relationship of retinopathy and hearing loss in type 2 diabetes mellitus
Annals of Ophthalmology (2002)
-
Ocular autonomic nerve function in Lambert-Eaton myasthenic syndrome
Eye (1990)
-
Autonomic denervation hypersensitivity in the primary glaucomas
Eye (1989)