The effects of pharmacological accommodation and cycloplegia on axial length and choroidal thickness

Bahar, Alperen; Pekel, Gökhan

doi:10.5935/0004-2749.20210015

Cited by 14 publications

(17 citation statements)

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“…In monkeys, cholinergic neurons mediate nitric oxide release to facilitate ophthalmic artery vasodilation 70 . Four studies found that that CT significantly decreases from baseline after administration of 1% cyclopentolate 21–24 . There have been conflicting findings on the association between tropicamide and SFCT.…”

Section: Resultsmentioning

confidence: 99%

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The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Yeung

Park

et al. 2022

Brit J Clinical Pharma

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The choroid plays an important role in various ocular pathologies and retinal blood supply. There is a knowledge gap on how the choroid is affected by systemic and topical medications. Systemic medications that affect microvasculature elsewhere in the body can also affect the microvasculature of the choroid. This review summarizes current knowledge on associations between systemic and topical medications and changes in choroidal thickness (CT). This review included 71 studies on mydriatics/cycloplegics, intraocular pressure (IOP)‐lowering therapies, antihypertensives, adrenergic antagonists, statins, corticosteroids, hydroxychloroquine, isotretinoin, hormonal contraceptives, phosphodiesterase inhibitors, antipsychotics, antineoplastic agents, ethanol, caffeine and nicotine. IOP‐lowering therapies, atropine eye drops, and systemic administration of β blockers and ethanol are associated with a significant increase in CT. Cyclopentolate and phenylephrine are associated with a CT reduction. Systemic medications that decrease CT include caffeine and nicotine. Tropicamide, angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, statins, corticosteroids, hydroxychloroquine and hormonal contraceptives have mixed findings. CT increase associated with IOP‐lowering therapies is possibly achieved by enhancing aqueous humour flow to the choroid thus elevating choroidal blood flow and thickness. CT changes appear to be independent from systemic blood pressure changes, suggesting that a significant association with an antihypertensive could be due to an idiosyncratic drug property. Statins and candesartan decrease macrophage accumulation and intercellular adhesion molecule 1 expression in the choroid. The choroid and its response to various disease processes and systemic medication can be further investigated to improve patient care, particularly in patients with choroid and retina pathologies.

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Section: Resultsmentioning

confidence: 99%

“…70 Four studies found that that CT significantly decreases from baseline after administration of 1% cyclopentolate. [21][22][23][24] There have been conflicting )…”

Section: Topical Mydriatics/cycloplegicsmentioning

confidence: 99%

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Yeung

Park

et al. 2022

Brit J Clinical Pharma

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“…In this study, we examined the effects of highconcentration of atropine (1%) and tropicamide on ocular biological parameters in children, and calculated the changes of parameters before and after cycloplegia (difference value: post-cycloplegia minus pre-cycloplegia, absolute value of difference: |post-cycloplegia minus pre-cycloplegia|). In previous studies, some scholars had con rmed that cycloplegia in children could lead to changes in AL, K, CCT and ACD, among which the most studies on ACD increased observably [7,11,[13][14][15][16][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…The ciliary paralysis reagents we used are mainly atropine as long-acting and tropicamide as short-acting. However, previous studies have shown that cycloplegia has a certain impact on ocular biological parameters, especially in children, including refractive state [10][11][12][13], axial length (AL) [11,[13][14][15][16], corneal curvature, axial position of corneal astigmatism, central corneal thickness (CCT) [10,[15][16][17][18][19],…”

Section: Introductionmentioning

confidence: 99%

Effects of Atropine and Tropicamide on Ocular Biological Parameters in Children: A Prospective Observational Study

Tao

Tan

Huang

et al. 2022

Preprint

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Background The effectiveness of cycloplegia in delaying the progression of myopia and its application in refractive examination in children have been extensively studied, but there are still few studies on the effects of atropine/tropicamide on ocular biological parameters. Therefore, the purpose of this study is to explore the effects of atropine/tropicamide on children's ocular biological parameters in different age groups, and the differences between them. Methods This was a prospective observational study in which all school children were examined for diopter and ocular biological parameters in the outpatient clinic, and 1% atropine and tropicamide were applied for the treatment. After examination, we enrolled the patients grouped by age (age from 2 to 12 years treated by atropine, 55 cases; age from 2 to 10 years treated by tropicamide, 70 cases; age from 14 to 17 years treated by tropicamide, 70 cases). The ocular biological parameters of each patient before and after cycloplegia were measured and the difference value and its absolute value were calculated for statistical analysis using independent-samples t-test. Results There was no significant difference in the difference value of ocular biological parameters and the absolute value of the difference in the same age groups before and after cycloplegia (P > 0.05). There were significant statistical differences in the corresponding values of AL, K1 and ACD among different age groups (P < 0.05). Before cycloplegia, there were significant differences in AL, K, K1, K2 and ACD in different age groups (P < 0.05). However, the differences in AL, K, K1, K2 and ACD among different age groups disappeared after cycloplegia (P > 0.05). Conclusions This study demonstrated that atropine/tropicamide have different effects on cycloplegia in children of different ages. The effects of atropine/tropicamide on ocular biological parameters should be fully taken into account when evaluating the refractive state before refractive surgery or calculating the degree of intraocular lens before cataract surgery.

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“…Contraction of the ciliary muscle increases compliance and decreases intraocular pressure. Pilocarpine is used to treat open-angle glaucoma and closed-angle glaucoma before surgery and to induce pupil narrowing after surgery or ophthalmoscopy (9). Tropicamide is an anticholinergic Corneal stability is essential for contact lenses and refractive surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison study between Pilocarpine and Tropicamide drops on corneal topography and their effect on IL-6 and TNF-α levels in tear

Zhang¹,

Zhao²

2022

Cell Mol Biol (Noisy-le-grand)

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The effects of pharmacological accommodation and cycloplegia on axial length and choroidal thickness

Cited by 14 publications

References 0 publications

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Effects of Atropine and Tropicamide on Ocular Biological Parameters in Children: A Prospective Observational Study

Comparison study between Pilocarpine and Tropicamide drops on corneal topography and their effect on IL-6 and TNF-α levels in tear

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