雙眼同步瞳孔量測儀之研發與應用

Abstract

眼睛除了提供視覺的能力，更能藉由分析其變化與狀態來揭示人類的生理狀況。其中特別的現象為瞳孔對光反應，該現象主要為調節瞳孔的進光量以防止視網膜受損，由自律神經所控制。自律神經病變通常不明顯且不易發現，現今的量測儀器與評估方法，因量化與變異性問題無法以數據方式判斷神經傳導之狀態。因而本研究希望透過瞳孔對光反應，研究神經傳導與自律神經病變。 本研究設計一種非侵入且可攜式之雙眼瞳孔量測儀，其包含兩種強度與四種波段之刺激光源，用以量測瞳孔大小、延遲時間與速率。本研究主要有兩大方向，其一為正常人之雙眼神經傳導探討；其二為正常人與自律神經病變之病患之瞳孔反應比較，如糖尿病患者與高雪氏症患者。 正常人神經傳導實驗證明雙眼延遲的差異性，光刺激到開始收縮時間刺激眼小於非刺激眼。糖尿病患實驗結果如下(1)休息時瞳孔大小糖尿病患者比正常人小(p=0.03)。(2)在0.12 cd的白光情形下，光刺激後到開始收縮之時間糖尿病患者比正常人長(p=0.016)。(3)最小瞳孔直徑恢復至50%改變量之時間，於任何光強度與波長情況下，糖尿病患者花費較長的時間(p=0.027)。(4)瞳孔最大收縮速率，糖尿病患者快於正常人在紅光與藍光之情形(p=0.043)。(5)白光與紅光下，瞳孔最大恢復速率，糖尿病患者較慢(p=0.045)。高雪氏症病患實驗結果如下(1)最小瞳孔直徑於紅光刺激高雪氏症病患大於正常人(p=0.004)。(2)最小瞳孔直徑恢復至50%改變量之瞳孔直徑，於紅光刺激高雪氏症病患大於正常人(p=0.004)。

Eye provides the ability of vision. In addition, its change and situation can reveal physiological state for human. The special phenomenon is pupillary light reflex. The purpose of this phenomenon is to adjust light which enters pupil and prevent retina from being impaired. It is controlled by autonomic nervous system. Autonomic neuropathy is usually unobvious and difficult to find. Because of quantification and variability, it does not distinguish the situation of neurotransmission by data in the current instruments and measurement methods. Therefore, this research studies the neurotransmission and autonomic neuropathy by pupillary light reflex. This study designs a non-invasive, portable, and binocular pupillometer. The light sources contain two intensity and four wavelength to measure pupil size, latency, and velocity. This study has two main directions. First, it studies binocular neurotransmission for healthy people. Second, pupil response is compared between normal and patients, such as diabetics and Gaucher disease. The experiment of neurotransmission proves the difference of latency through dissimilar resolution preliminarily for normal. The latency of stimulated eye is shorter than unstimulated eye. The experimental results for diabetics are as follows: The resting pupil diameter of diabetics is smaller than normal (p=0.03). Diabetics have longer time to constriction under white light and intensity of 0.12cd (p=0.016). Duration between the minimum pupil size restoring to the 50% pupil size for diabetics is longer than normal under different luminous intensity and wavelength (p=0.027). The maximum pupil constriction velocity is faster than healthy people under red and blue (p=0.043). Maximum pupil restoration velocity is slower than normal under white and red light (p=0.045). The experimental results for Gaucher disease are as follows: Minimum pupil diameter and restoring to 50% pupil diameter are larger than healthy people under red light (p=0.004).