WordNet

desert (a cause, a country or an army), often in order to join the opposing cause, country, or army; "If soldiers deserted Hitlers army, they were shot" (同)desert
an imperfection in an object or machine; "a flaw caused the crystal to shatter"; "if there are any defects you should send it back to the manufacturer" (同)fault, flaw
an imperfection in a bodily system; "visual defects"; "this device permits detection of defects in the lungs"
a failing or deficiency; "that interpretation is an unfortunate defect of our lack of information" (同)shortcoming
estimated by comparison; not absolute or complete; "a relative stranger" (同)comparative
an animal or plant that bears a relationship to another (as related by common descent or by membership in the same genus) (同)congener, congenator, congeneric
a person related by blood or marriage; "police are searching for relatives of the deceased"; "he has distant relations back in New Jersey" (同)relation
of nerves and nerve impulses; conveying sensory information from the sense organs to the CNS; "afferent nerves"; "afferent impulses"
of or relating to the pupil of the eye

PrepTutorEJDIC

〈C〉『欠点』,弱点,欠陥 / 〈U〉〈C〉《古》不足,欠乏 / (国・党・主義などから)離脱する,裏切って出る《+『from』+『名』》;離反して(…に)転向する《+『to』+『名』》
『関係のある』,関連した / 『比較上の』,相対的の / 相互の,相関的な / (文法で)関係を表す / 親類,親戚 / 関係詞,(特に)関係代名詞
(神経・血管などが)求心性の(末梢(まっしょう)から中枢に向かうこと)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/19 01:02:02」(JST)

wiki en

Marcus Gunn pupil or relative afferent pupillary defect (RAPD) is a medical sign observed during the swinging-flashlight test^[1] whereupon the patient's pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye. The affected eye still senses the light and produces pupillary sphincter constriction to some degree, albeit reduced.

The most common cause of Marcus Gunn pupil is a lesion of the optic nerve (between the retina and the optic chiasm) or severe retinal disease. It is named after Scottish ophthalmologist Robert Marcus Gunn.^[2]

Examination

The Marcus Gunn pupil is a relative afferent pupillary defect indicating a decreased pupillary response to light in the affected eye.^[3]

In the swinging flashlight test, a light is alternately shone into the left and right eyes. A normal response would be equal constriction of both pupils, regardless of which eye the light is directed at. This indicates an intact direct and consensual pupillary light reflex. When the test is performed in an eye with an afferent pupillary defect, light directed in the affected eye will cause only mild constriction of both pupils (due to decreased response to light from the afferent defect), while light in the unaffected eye will cause a normal constriction of both pupils (due to an intact efferent path, and an intact consensual pupillary reflex). Thus, light shone in the affected eye will produce less pupillary constriction than light shone in the unaffected eye.

A Marcus Gunn Pupil is distinguished from a total CN II lesion, in which the affected eye perceives no light. In that case, shining the light in the affected eye produces no effect.

Anisocoria is absent. A Marcus Gunn pupil is seen, among other conditions, in optic neuritis. It is also common in retrobulbar optic neuritis due to multiple sclerosis but only for 3–4 weeks, until the visual acuity begins to improve in 1–2weeks and may return to normal.^[4]

References

^ "utah.edu". Retrieved 2009-05-27.
^ doctor/2687 at Who Named It?
^ Pearce J (November 1996). "The Marcus Gunn pupil". J. Neurol. Neurosurg. Psychiatr. 61 (5): 520. doi:10.1136/jnnp.61.5.520. PMC 1074053. PMID 8937350.
^ Mumenthaler Neurology 4ed, Thieme 2004, page 486 Demyelinating diseases

External links

1611005962 at GPnotebook

This medical sign article is a stub. You can help Wikipedia by expanding it.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人における詳細な神経学的検査 the detailed neurologic examination in adults
2. 瞳孔不同患者へのアプローチ approach to the patient with anisocoria
3. 視神経炎：病態生理、臨床的特徴、および診断 optic neuritis pathophysiology clinical features and diagnosis
4. 急性持続性視力喪失が認められた成人に対するアプローチ approach to the adult with acute persistent visual loss
5. 成人における多発性硬化症の臨床的特徴 clinical features of multiple sclerosis in adults

English Journal

Choroid vascular occlusion and ischemic optic neuropathy after facial calcium hydroxyapatite injection- a case report.

Chou CC1, Chen HH, Tsai YY, Li YL, Lin HJ.
BMC surgery.BMC Surg.2015 Dec;15(1):7. doi: 10.1186/s12893-015-0007-3. Epub 2015 Mar 8.
BACKGROUND: We reported a case of sudden monocular vision loss after calcium hydroxyapatite (CaHA) injection into the nasal tip and dorsum with detailed retina images.CASE PRESENTATION: A healthy, 35-year-old woman received CaHA filler injection for nose augmentation. Ten minutes after the procedure
PMID 25778722

A Novel Computerized Portable Pupillometer Detects and Quantifies Relative Afferent Pupillary Defects.

Cohen LM1, Rosenberg MA, Tanna AP, Volpe NJ.
Current eye research.Curr Eye Res.2015 Feb 6:1-8. [Epub ahead of print]
Abstract Purpose: A test of validation study was conducted to investigate the use of a novel computerized portable pupillometer to detect and quantify relative afferent pupillary defects (RAPDs). Materials and methods: Binocular pupillary response curves were recorded in patients with RAPDs clinical
PMID 25658805

Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation.

Olcaysu OO1, Cadirci K2, Altun A3, Durur Karakaya A4, Bayramlar H5.
Case reports in ophthalmological medicine.Case Rep Ophthalmol Med.2015;2015:687829. doi: 10.1155/2015/687829. Epub 2015 Jan 29.
Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her lef
PMID 25705536

Japanese Journal

健常者における暗順応時間がRAPDx®の測定結果と再現性に及ぼす影響

神経眼科 32(3), 263-268, 2015
NAID 130005103872

うっ血乳頭が先行した急性散在性脳脊髄炎による視神経炎の1例

神経眼科 31(1), 39-44, 2014
NAID 130004672132

光覚消失からステロイドパルス療法で視力が改善した視神経炎の1例

東京女子医科大学雑誌 82(E1), E226-E229, 2012-01-31
NAID 110008767981

Related Pictures

★リンクテーブル★

リンク元	「交互点滅対光反射試験」「相対的求心性瞳孔障害」「RAPD」
関連記事	「relative」「defect」「afferent」「pupillary defect」「afferents」

「交互点滅対光反射試験」

Marcus Gunn pupil
	The left optic nerve and the optic tracts. A Marcus Gunn pupil indicates an afferent defect, usually at the level of the retina or optic nerve. Moving a bright light from the unaffected eye to the affected eye would cause both eyes to dilate, because the ability to perceive the bright light is diminished.
Classification and external resources
DiseasesDB	29599

　　[★]

英: swinging flashlight test
同: 交互対光反射試験
関: 相対的瞳孔求心路障害 relative afferent pupillary defect RAPD。マーカスガン瞳孔 Marcus Gunn pupil

検査方法：左右の眼に交互に光を当てる。
異常の判断：患側に光を入れても患側の瞳孔が収縮しない。

正常：光＞　・　　○

　　　　　　○　　・　＜光

異常：　　　　　(右眼)
　　　光＞　・　　○

　　　　　　○　　◎　＜光

　　　光＞　・　　○

異常が出るメカニズム：患側の直接反応は、健側の間接反応の方が弱い。そのため、健側から患側に光を当てると、患側の瞳孔が拡張する。
視神経障害(外傷性視神経障害、視神経炎、末期緑内障など)、広範な網膜障害(重度の網膜剥離)
異常がある場合、相対的求心路瞳孔反応異常あり(RAPD relative afferent papillary defect)という。

「相対的求心性瞳孔障害」

　　[★]

英: relative afferent pupillary defect, RAPD
同: 相対的瞳孔求心路障害
関: 対光反応、縮瞳異常、瞳孔不同(出力系の異常)。交互点滅対光反射試験

[show details]

相対的求心性瞳孔障害 : 32 件
相対的瞳孔求心路障害 : 25 件

相対的求心性瞳孔障害 RAPD : 20 件
相対的瞳孔求心路障害 RAPD : 14 件

入力系の異常、例えば視神経の異常を示唆する。
一方の眼に光を照射したときと、他方の眼に光を照射したときの縮瞳量に左右差がある場合にはRAPDがあるといい、誘発縮瞳量の小さい側の入力系に異常があることが考えられる。

「RAPD」

　　[★]

相対的求心性瞳孔障害 relative afferent pupillary defect

「relative」

　　[★]

adj.

相対的な、相対の、相対性の、関連性の、関する、関連する

n.

親類、親戚、類縁体

関: about、analog、analogue、associate、association、attach、bearing、concern、connection、correlate、correlation、derivative、family、family member、implication、link、pertinent、reference、regard、relate、relatedness、relation、relationship、relatively、relativity、relevance、relevant

「defect」

　　[★]

n.

欠損、欠損症、異常、欠陥、欠点

関: aberrant、aberrantly、aberration、abnormal、abnormality、abnormally、absence、agenesis、anomalous、anomalously、anomaly、defective、deficiency、deficient、deficit、deletion、deletional、deviant、drawback、extraordinarily、extraordinary、fault、flaw、inadequacy、miss、missing、morphological defect、shortcoming、unusual、unusually、weakness

「afferent」

　　[★]

adj.

求心性の、求心の、輸入の

n.

求心路、求心性神経、求心性線維

関: afferent fiber、afferent fibre、afferent neuron、afferent pathway、afferents、centripetal、concentric、import、importation

「pupillary defect」

　　[★]

瞳孔異常、瞳孔障害

関: pupillary abnormality、pupillary disorder

「afferents」

　　[★]

n.

求心路

関: afferent、afferent pathway

[1] "utah.edu". Retrieved 2009-05-27.

[2] doctor/2687 at Who Named It?

[pmid8937350-3] Pearce J (November 1996). "The Marcus Gunn pupil". J. Neurol. Neurosurg. Psychiatr. 61 (5): 520. doi:10.1136/jnnp.61.5.520. PMC 1074053. PMID 8937350.

[4] Mumenthaler Neurology 4ed, Thieme 2004, page 486 Demyelinating diseases

匿名

検索

案内

案内

relative afferent pupillary defect