PUPILLARY REACTIONS IN MENIERE'S DISEASE

Abstract

To clarify the pupillary reactions in Meniere's disease, the pupil diameters of both eyes were measured simultaneously on 39 patients with Meniere's disease, 18 dizzy patients not related with Meniere's disease, and 26 normal subjects. An infrared pupillometer, manufactured for trial at Institute for Medical and Dental Engineering, Tokyo Medical and Dental University, was used for this purpose. The results obtained were as follows;
1. 11% of the patients with Meniere's disease, 13% of the dizzy patients not related with Meniere's disease and 12% of the normal subjects showed anisocoria in the ordinary condition.
2. Two drops of 0.1% pilocarpine, topically applied to both eyes, induced anisocoria in 26% of the patients with Meniere's disease, 44% of the dizzy patients not related with Meniere's disease and 9% of the normal subjects. Topical application of pilocarpine seems to bring about anisocoria more frequently in the patients with dizziness or vertigo than in the normal subjects.
3. As far as the light reflex is concerned, 38% of the patients with Meniere's disease showed the delay of redilation phase, particularly the delay of the second redilation phase, and even hippus. This emphatically indicates that Meniere's disease has a much higher tendency to it than the other causes of vertigo or dizziness, and the normal group. According to the previous literatures, the second redilation phase of the pupillary reaction is regulated by the sympathetic nervous system. Based on this fact, this abnormality is considered to be due to the abnormality in the sympathetic nervous system.
4. Breath holding or hyperventilation induced the disappearance of the hippus in the ordinary condition and the delay of the redilation phase.
From these observations, the auther concluded that Meniere's disease was closely related to the abnormality of the autonomic nervous system, especially the sympathetic nervous system.