Bilateral tonic pupils: Holmes-Adie syndrome or generalised neuropathy?

Bremner, Fion; Smith, Stephen

doi:10.1136/bjo.2007.118968

Cited by 28 publications

(32 citation statements)

References 7 publications

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“…For example, patients with bilateral tonic pupils may have Holmes-Adie syndrome (a relatively benign diagnosis) or a more generalized neuropathy (which potentially carries a worse prognosis). Both diagnostic groups show evidence of parasympathetic loss, but anisocoria >1 mm and sector palsy are seen much more commonly in HAS; the presence of these particular features can be used to distinguish between these two groups with a sensitivity of 58% and a specificity of 90% [7].…”

Section: J Patient Confoundersmentioning

confidence: 99%

Pupil evaluation as a test for autonomic disorders

Bremner

2009

Clin Auton Res

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Pupil tests provide a convenient and simple method for evaluation of autonomic function. Most patients with autonomic disorders show evidence of sympathetic or parasympathetic deficits in the pupil, and these can be detected using a combination of clinical signs, pupillometric tests (measuring the responses to light, or an accommodative effort, or a sudden noise) and pharmacological tests (using topically applied drugs both to confirm a deficit and to localize the lesion). Caution is needed in the interpretation of these tests, particularly if the deficits are mixed (i.e. sympathetic and parasympathetic) or bilateral. The pattern of autonomic disturbance in the pupils often correlates poorly with autonomic function elsewhere, but may have diagnostic value in discriminating between different underlying conditions.

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Section: J Patient Confoundersmentioning

confidence: 99%

Pupil evaluation as a test for autonomic disorders

Bremner

2009

Clin Auton Res

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“…Bilateral HAS has been discussed in the literature [5]. And in such cases it is important to differentiate it from generalised peripheral neuropathy, i.e.…”

Section: Discussionmentioning

confidence: 99%

Holmes-Adie syndrome

Sirang

Jeeva

2019

Ophthalmol J

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Holmes-Adie syndrome (HAS) is a rare neuro-ophthalmological disorder, which mostly presents in young females as a unilateral dilated pupil. We present a case of a 12-year-old girl with bilateral tonic pupils. She had vermiform movement of the iris with segmental palsy, as well as loss of ankle jerks. The diagnosis was confirmed with pilocarpine 0.125% test, and she was symptomatically treated with the same drops.

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“…9 Yaygın periferik veya otonomik nöropatili olgularda gelişen tonik pupilla sıklıkla çift taraflı tutulum sergilerler. Bremner ve ark.…”

Section: Discussionunclassified

“…Bremner ve ark. 9 bilateral tonik pupillalı olgularda yaptıkları bir çalışmada, 1 mm'den büyük anizokori ve iriste bölgesel felç bulunan olguların, %90 spesifite oranı ile jeneralize nöropati sonucu oluşmadıklarını göstermiştir. Benzer şekilde her iki gözde 1 mm'den büyük anizokori ve iriste bölgesel felci olmayan olgularda yaygın periferik veya otonomik nöropati saptamıştır.…”

Section: Discussionunclassified

Bilateral Adie’nin Tonik Pupillası

Bakbak¹,

Ekinci²,

Gedik³

et al. 2014

tjo

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ÖzetIşığa hassasiyet ve okumada zorlanma şikayeti ile başvuran 37 yaşındaki erkek hastada bilateral, geniş, ışığa yanıt vermeyen ancak yakına bakışta küçülen pupilla saptandı. Nörolojik, radyolojik ve laboratuar değerlendirmelerin ardından hastaya bilateral tonik pupilla tanısı kondu. Tonik pupilla, ışık-yakın disosiyasyonu saptanan gözlerde ayırıcı tanıda düşünülmesi gereken bir durumdur. Bu olgu raporunda ender rastlanılan bilateral tonik pupilla ve bu klinik tablonun oluşum mekanizması tartışıldı. ( Sum maryA 37-year-old male patient applied with the complaint of photophobia and having difficulties in reading. Both pupils were found to be dilated and unreactive to light but responsive to accommodation. The case was diagnosed with bilateral tonic pupil following neurological, radiological and laboratory evaluations. Tonic pupil should be kept in mind in eyes with light-near dissociation. In this case report, bilateral tonic pupils and the possible mechanism which may cause this disorder were discussed. (Turk J Ophthalmol 2013; 43: 64-6)

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Bilateral tonic pupils: Holmes-Adie syndrome or generalised neuropathy?

Cited by 28 publications

References 7 publications

Pupil evaluation as a test for autonomic disorders

Pupil evaluation as a test for autonomic disorders

Holmes-Adie syndrome

Bilateral Adie’nin Tonik Pupillası

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