Gamze YILDIRIM BİÇER, Çağatay Emir ÖNDER, Kürşad Ramazan ZOR

Graves hastalığında pupiller yanıt değişiklikleri

Amaç: Bu çalışmanın amacı, Graves hastalığında pupiller kontraksiyon ve dilatasyon yanıt değişikliklerini araştırmaktı. Gereç ve Yöntem: Hasta grubu 55 ötroid Graves hastasından ve kontrol grubu 55 sağlıklı bireyden oluşuyordu. Tüm katılımcıların sağ gözlerinden elde edilen veriler kullanıldı. Otomatik pupillometri ile statik (skotopik, mezopik, fotopik) ve dinamik pupillometri ölçümleri yapıldı. Dinamik ölçümlere göre ortalama pupil dilatasyon hızı hesaplandı. Hasta ve kontrol grupları arasında statik ölçümler, dinamik ölçümler ve ortalama pupil dilatasyon hızı verileri karşılaştırıldı. Bulgular: Tüm statik ve dinamik değerler ve ortalama pupil dilatasyon hızı açısından iki grup arasında fark yoktu. Ortalama skotopik pupil çapı Graves grubunda 5,41±0,776 mm, kontrol grubunda 5,55±0,747 mm; ortalama mezopik pupil çapı Graves grubunda 4,39±0,721 mm, kontrol grubunda 4,17±0,640 mm; ortalama fotopik pupil çapı Graves grubunda 3,45 ±0,549 mm, kontrol grubunda 3,29±0,679 mm; ortalama dinamik pupil çapı 0. saniye Graves grubunda 3,54±0,541 mm, kontrol grubunda 3,48±0,708 mm; 18. saniyede ortalama pupil dilatasyon hızı Graves grubunda 0,116±0,031 mm/sn, kontrol grubunda 0,128±0,040 mm/sn olarak saptandı. Yaş pupiller parametreleri etkileyen bağımsız bir faktör olarak bulundu. Sonuç: Graves hastalığında muhtemel bir otonomik bozukluk bildirilse de ötroidi durumundaki hastaların pupiller parametrelerinin etkilenmediği sonucuna vardık. Ötroidi durumunda pupiller yanıtlar etkilenmiyor gibi görünse de hipotroidi ve hipertroidi hastalarının da dahil edildiği çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

otonom sinir sistemi, Graves hastalığı, pupil dilatasyon hızı, pupillometri, tiroid fonksiyon testleri

Pupillary response changes in Graves' disease

Purpose: The aim of this study was to investigate pupillary contraction and dilatation response changes in Graves' disease. Materials and Methods: The patient group consisted of 55 euthyroid Graves patients and the control group consisted of 55 healthy individuals. Data from the right eyes of all participants were used. Static (scotopic, mesopic, photopic) and dynamic pupillometry measurements were performed with automatic pupillometry. The mean pupil dilatation speed was calculated according to dynamic measurements. Static measurements, dynamic measurements and the mean pupil dilatation speed data were compared between the patient and control groups. Results: There was no statistically significant difference between two groups in all static and dynamic values and the mean pupil dilatation speed. The mean scotopic pupil diameter was 5.41±0.776 mm in Graves’ group and 5.55±0.747 mm in the control group. The mean mesopic pupil diameter was 4.39±0.721 in Graves’ group and 4.17±0.640 mm in the control group. The mean photopic pupil diameter was 3.45 ±0,549 mm in Graves’ group and 3.29±0.679 mm in the control group. The mean dynamic pupil diameter 0th second was 3, 54±0.541 mm in Graves’ group and 3.48±0.708 mm in the control group. The mean speed of pupil dilatation at 18th second was 0.116±0.031 mm/sec in Graves’ group and 0.128±0.040 mm/sec in the control group. Age was found to be an independent factor on pupillary parameters. Conclusion: The pupillary parameters of patients with euthyroid hormone levels were not affected. While pupillary responses appeared not to be affected in the case of euthyroidism, more studies including patients with hypothyroidism and hyperthyroidism are needed.

Keywords:

autonomic nervous system, pupil dilatation speed, pupillometry, thyroid function tests, Graves,

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