Autonomic Pupillary Light Response in Central Serous Chorioretinopathy

Year 2025, Volume: 14 Issue: 1, 179 - 183, 28.03.2025

Durgül Açan , Yurdagül Girgin , Eyup Karahan

Abstract

Objective: The aim of the study is to evaluate the autonomic nervous system (ANS) activity by assessing static and dynamic pupillary light responses in central serous chorioretinopathy (CSCR). Materials and Methods: A case-control study. Thirty eyes of 30 patients with CSCR who were previously diagnosed in our clinic were included in the study group, and 31 right eyes of 31 healthy participants were included in the control group. All participants underwent a complete ophthalmologic examination. Static and dynamic pupillometry values were measured with the Scheimpflug/Placido photo-based topography system, Sirius topographer (CSO, Firenze, Italy) and pupillary dilation velocities were calculated and compared between the groups. Results: The mean scotopic, mesopic, photopic pupil diameters as well as scotopic/photopic ratios were not statistically different in the study and control groups, with values of 4.98±0.87 mm vs. 5.05±0.98 mm, 3.86±0.82 mm vs. 3.86±0.83 mm, 2.94±0.60 mm vs. 2.87±0.57 mm and 1.72±0.20 vs. 1.77±0.22, respectively (p1=0.759, p2=0.997, p3=0.676, p4=0.304). Dynamic pupillometric values were also similar between the groups (p>0.05). Pupillary dilatation velocity was slower in the study group during the 2-4 second interval (p=0.013). Conclusion: Pupillary responses mediated by the ANS in CSCR patients are similar to those of healthy participants. This suggests that systemic hormonal factors and local choroidal responses, rather than sympathetic activation, should be prioritized in understanding the pathophysiology of CSCR.

Keywords

Autonomic Nervous System, Central Serous Chorioretinopathy, Pupillary Reflex

Santral Seröz Koryoretinopati'de Otonom Pupil Işık Yanıtı

Abstract

Amaç: Çalışmanın amacı santral seröz korioretinopatide (SSKR) statik ve dinamik pupil ışık yanıtlarını değerlendirerek otonom sinir sistemi (OSS) aktivitesini değerlendirmektir. Gereç ve Yöntem: Bir vaka-kontrol çalışması. Kliniğimizde daha önce tanı almış 30 SSKR hastasının 30 gözü çalışma grubuna, 31 sağlıklı katılımcının 31 sağ gözü ise kontrol grubuna dahil edildi. Tüm katılımcılara tam bir oftalmolojik muayene yapıldı. Statik ve dinamik pupillometre değerleri Scheimpflug/Placido foto-tabanlı topografi sistemi, Sirius topografı (CSO, Floransa, İtalya) ile ölçüldü ve pupil dilatasyon hızları hesaplandı ve gruplar arasında karşılaştırıldı. Bulgular: Çalışma ve kontrol gruplarında ortalama skotopik, mezopik, fotopik pupil çapları ve skotopik/fotopik oranlar istatistiksel olarak farklı değildi; sırasıyla 4,98±0,87 mm ile 5,05±0,98 mm, 3,86±0,82 mm ile 3,86±0,83 mm, 2,94±0,60 mm ile 2,87±0,57 mm ve 1,72±0,20 ile 1,77±0,22 idi (p1=0,759, p2=0,997, p3=0,676, p4=0,304). Dinamik pupillometrik değerler de gruplar arasında benzerdi (p>0,05). Çalışma grubunda pupil dilatasyon hızı 2-4 saniyelik aralıkta daha yavaştı (p=0,013). Sonuç: SSKR hastalarında OSS tarafından yönetilen pupilla yanıtları sağlıklı katılımcıların yanıtlarına benzerdir. Bu, SSKR'nin patofizyolojisini anlamada sempatik aktivasyondan ziyade sistemik hormonal faktörler ve lokal koroidal yanıtların önceliklendirilmesi gerektiğini düşündürmektedir.

Keywords

Otonom Sinir Sistemi, Santral Seröz Koryoretinopati, Pupiller Refleks

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