メニエール病患者の瞳孔反応

抄録

In order to clarify autonomic dysfunction as a cause of Meniere's disease, the difference between the pupillary areas of both eyes, the light reflex test and mecholyl test by means of conjunctival instillation were examined in normal subjects and patients with Meniere's disease. The results obtained were as follows; 1. The difference in the pupillary area between both eyes was not found even at attack stages of Meniere's disease. 2. In the light reflex test, both the mean velocity of miosis and the velocity of miosis at the half contraction were slower in patients with Meniere's disease than normal subjects, however, they did not differ between the eyes of the affected and unaffected sides. This shows suppression of the contraction phase in patients with Meniere's disease. Shortend half dilatation time found on the affected side at the attack stage shows activation of dilatation phase. On the other hand, the mean velocity of half dilatation on the affected and unaffected sides were slower in patients with Meniere's disease at the interval stage than normal subjects, showing suppression of dilatation phase.
In summary, the patients with Meniere's disease seem to be under the condition with activated parasympathetic nerve at the interval stage and under the condition with suppressed parasympathetic nerve at the attack stage. 3. In the conjunctival instillation test with 5% mecholyl, patients with Meniere's disease showed high appearance rate of significant miosis. However, the appearance rate of abnormalities were higher and the affected- than the unaffected side at both the quasi-attack and attack stage. Furthermore, as the pathological stage advanced, the rate of contration (miosis) became higher in the same patients. 4. The advantages of the light reflex test and the mecholyl test were comparatively evaluated in the same patients. The results revealed that the mecholyl test is more sensitive than the light reflex test in detecting abnormalities in autonomic nerve system of the patients with Meniere's disease.
From these results, it was surmised that the suppression of parasympathetic nerve system on the affected side may play a role to involve attacks of Meniere's disease.