Does dilute pilocarpine detect early diabetic autonomic neuropathy in diabetic patients?
Pupillary denervation hypersensitivity to dilute pilocarpine is an early marker of diabetic autonomic neuropathy, preceding cardiovascular autonomic changes.
Denervation hypersensitivity to dilute pilocarpine is a result of damage to the pupillary parasympathetic supply of diabetic patients. This occurs before the pupillary sympathetic pathway is affected, it can be detected early in the disease, and it may be a possible explanation for the small pupil size seen in diabetic patients. Pupillary autonomic dysfunction occurs before cardiovascular autonomic changes and detection of pupil denervation hypersensitivity to dilute pilocarpine is an inexpensive way to detect early DAN.
Mary R. Cahill (Mon,) studied this question.
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