afferent pupillary defect

求心性瞳孔障害、求心路瞳孔障害

関

fixed pupil、Marcus-Gunn pupil、pupil disorder、pupillary disorder

WordNet

1. 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
2. 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
3. an imperfection in a bodily system; "visual defects"; "this device permits detection of defects in the lungs"
4. a failing or deficiency; "that interpretation is an unfortunate defect of our lack of information" (同)shortcoming
5. of nerves and nerve impulses; conveying sensory information from the sense organs to the CNS; "afferent nerves"; "afferent impulses"
6. of or relating to the pupil of the eye

PrepTutorEJDIC

1. 〈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』》
2. (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）』「2015/12/09 01:22:21」(JST)

wiki en

[Wiki en表示]

For the jaw-winking syndrome, see Marcus Gunn phenomenon.

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

Marcus Gunn pupil or relative afferent pupillary defect (RAPD) is a medical sign observed during the swinging-flashlight test 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.

Examination

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

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.

See also

• Adie syndrome
• Anisocoria
• Cycloplegia
• Miosis
• Parinaud's syndrome
• Syphilis

References

External links

• 1611005962 at GPnotebook

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. 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
• 3. 瞳孔不同患者へのアプローチ approach to the patient with anisocoria
• 4. 視神経症 optic neuropathies
• 5. 眼球開放創：緊急評価および初期マネージメント open globe injuries emergent evaluation and initial management

English Journal

• Depressed Adolescents' Pupillary Response to Peer Acceptance and Rejection: The Role of Rumination.

• Stone LB1, Silk JS2,3, Siegle GJ2,3, Lee KH2, Stroud LR4, Nelson EE5, Dahl RE6, Jones NP2.
• Child psychiatry and human development.Child Psychiatry Hum Dev.2016 Jun;47(3):397-406. doi: 10.1007/s10578-015-0574-7.
• Heightened emotional reactivity to peer feedback is predictive of adolescents' depression risk. Examining variation in emotional reactivity within currently depressed adolescents may identify subgroups that struggle the most with these daily interactions. We tested whether trait rumination, which am
• PMID 26271345

• Bilateral optic neuropathy following bite from brown recluse spider (Loxosceles reclusa).

• Mantopoulos D1, Hendershot AJ1, Cebulla CM1, Hirsh DK1.
• Cutaneous and ocular toxicology.Cutan Ocul Toxicol.2016 Jun;35(2):168-72. doi: 10.3109/15569527.2015.1027906. Epub 2015 Apr 14.
• A 63-year-old female with history of a resected frontal lobe meningioma presented with bilaterally decreased vision after a bite from a brown recluse spider. The exam was significant for a left relative afferent pupillary defect, bilateral optic nerve pallor, decreased foveal sensitivity in the left
• PMID 25869060

• Disc-damage Likelihood Scale (DDLS) as a Clinical Indicator of the Presence of a Relative Afferent Pupillary Defect (RAPD).

• Zhang AY1, Lu L, Ali M, Rutnin N, Faria BM, Guzel H, Liang L, Martinez P, Tawfik M, Spaeth GL.
• Journal of glaucoma.J Glaucoma.2016 Apr 29. [Epub ahead of print]
• PURPOSE: To evaluate clinical parameters and their relationship to the presence of a relative afferent pupillary defect (RAPD).MATERIALS AND METHODS: Retrospective chart review of 672 consecutive patients who presented to the Glaucoma Service at Wills Eye Hospital from January 1 through May 29, 2012
• PMID 27136083

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 Links

• afferent pupillary defect - multiple sclerosis encyclopaedia

Afferent Pupillary Defect (APD) or Marcus-Gunn pupil is a condition of the eye where the pupil doesn't dilate appropriately to the level of light reaching it. This will often result in one pupil appearing larger than the other (relative afferent ...

• Afferent pupillary defect | definition of Afferent pupillary defect ...

Looking for online definition of Afferent pupillary defect in the Medical Dictionary? Afferent pupillary defect explanation free. What is Afferent pupillary defect? Meaning of Afferent pupillary defect medical term. What does Afferent ...

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★リンクテーブル★

リンク元	「マーカス・ガン瞳孔」「求心性瞳孔障害」「pupillary disorder」「fixed pupil」「pupil disorder」
拡張検索	「relative afferent pupillary defect」
関連記事	「defect」「afferent」「pupillary defect」「afferents」「pupillary」

「マーカス・ガン瞳孔」

　　[★]

英

Marcus-Gunn pupil, Marcus Gunn pupil

同

Marcus-Gunn瞳孔、ガン瞳孔 Gunn pupil

関

固定瞳孔 fixed pupil、瞳孔疾患 pupil disorder pupillary disorder、瞳孔障害、求心性瞳孔障害 afferent pupillary defect、、

• 視交差より末梢側の障害による対光反射での瞳孔径不同

「求心性瞳孔障害」

　　[★]

英

afferent pupillary defect

関

固定瞳孔、瞳孔疾患、瞳孔障害、求心路瞳孔障害、マーカス・ガン瞳孔

「pupillary disorder」

　　[★]

瞳孔障害

関

afferent pupillary defect、fixed pupil、Marcus-Gunn pupil、pupil disorder、pupillary defect

「fixed pupil」

　　[★]

固定瞳孔

関

afferent pupillary defect、Marcus-Gunn pupil、pupil disorder、pupillary disorder

「pupil disorder」

　　[★]

• 瞳孔疾患

関

afferent pupillary defect、fixed pupil、Marcus-Gunn pupil、pupillary disorder

「relative afferent pupillary defect」

　　[★] 相対的求心性瞳孔障害, RAPD

「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

「pupillary」

　　[★]

• adj.

• 瞳孔の

関

pupil