The use of pupillometry in joint and connective tissue diseases
| Autor: | Marco Matucci-Cerinic, Massimo Zoppi, Nicola Colangelo, Angela Del Rosso, Luca Bertinotti, Umberto Pietrini, Roberto Casale |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Sympathetic nervous system Sympathetic Nervous System Iris sphincter muscle Connective tissue Diagnostic Techniques Ophthalmological Substance P Reflex Pupillary General Biochemistry Genetics and Molecular Biology Pupil Autoimmune Diseases Parasympathetic nervous system History and Philosophy of Science Parasympathetic Nervous System Pupil Disorders Internal medicine Rheumatic Diseases Medicine Humans Connective Tissue Diseases Neurotransmitter Agents Scleroderma Systemic business.industry General Neuroscience Autonomic nervous system medicine.anatomical_structure Endocrinology Sjogren's Syndrome Cardiology Reflex Dry Eye Syndromes Joint Diseases business Pupillometry |
| Zdroj: | Annals of the New York Academy of Sciences. 966 |
| ISSN: | 0077-8923 |
| Popis: | The central and peripheral nervous systems are variably affected in the rheumatic diseases. Automated standardized infrared pupillometry allows the safe, noninvasive assessment of the pupillary innervation. Pupillometry has already been used in studying the autonomic nervous system (ANS) in various rheumatic diseases. In systemic lupus erythematosus, the irideal parasympathetic branch of ANS was more affected then the sympathetic branch. In Sjogren's syndrome, signs of pupillary parasympathetic denervation have been reported. In rheumatoid arthritis, pupil parasympathetic dysfunction has been shown to correlate with ocular dryness. In systemic sclerosis (SSc), both sympathetic and parasympathetic irideal impairment have been demonstrated. Beside providing autonomic innervation, sensory nerves fibers are able to control iris diameter. Exogenous ocular instillation of substance P (SP), a sensory neuropeptide, can determine an omathropine-resistant, non-cholinergic myosis, acting on specific receptors present on the iris sphincter muscle. We first studied pupillary SP-ergic responsiveness in SSc, evaluating substance P (SP)-stimulated pupillary diameters by pupillometry. A higher basal and SP-stimulated myosis was found in lSSc versus both dSSc and controls, whereas no differences existed between dSSc and controls. From the literature, the pupillary parasympathetic nervous system seems to be more affected than the sympathetic branch of ANS in the rheumatic diseases characterized by an inflammatory status. However, we found in SSc both sympathetic and parasympathetic pupil control to be equally impaired. From our experience, we conclude that pupillary nervous control is differently affected in the two subsets of SSc, and that the SP-ergic system seems to be impaired only in lSSc. |
| Databáze: | OpenAIRE |
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