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Chronic Chagas disease patients show ocular parasympathetic dysfunction, evidenced by pupillary abnormalities and pilocarpine hypersensitivity. This study highlights potential autonomic nervous system impacts on the eye in Chagas patients.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Neurology

Background:

  • Chagas disease, caused by Trypanosoma cruzi, can affect various organ systems.
  • Ocular manifestations in Chagas disease are not well-characterized, particularly concerning autonomic innervation.

Purpose of the Study:

  • To investigate parasympathetic innervation abnormalities in the iris sphincter and ciliary muscles in chronic Chagas disease.
  • To assess pupillary diameter and intraocular pressure in Chagas disease patients.

Main Methods:

  • Compared 80 Chagas disease patients with 76 healthy controls.
  • Performed pupillometry, pilocarpine hypersensitivity testing, and intraocular pressure (IOP) measurement.
  • Evaluated basal pupil diameter (BPD), pupillary constriction amplitudes (ACA, RCA), and anisocoria.

Main Results:

  • Higher prevalence of anisocoria in Chagas patients (p<0.01).
  • Chagas patients exhibited significantly lower mean basal and photopic pupil diameters and absolute pupillary constriction amplitude.
  • Hypersensitivity to dilute pilocarpine observed in 10% of Chagas patients; IOP showed marginal significance.

Conclusions:

  • Chagasic infection is associated with ocular parasympathetic dysfunction.
  • Pupillometry and pilocarpine hypersensitivity tests can detect this dysfunction.