Determinants of post-mydriatic intraocular pressure in phakic eyes with prevalent angle closure diseases

Ko, Yu Chieh; Kuo, Che Yuan; Kuang, Tung-Mei; Chen, Wei Ta; Chou, Pesus; Liu, Catherine Jui Ling

doi:10.1007/s00417-020-04941-z

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…While the risk of acute angle-closure attack may be low in eyes with narrow angles under pharmacological dilatation,[ 41 46 47 48 ] postdilation IOP elevation has been observed in this population. [ 33 41 49 ] Apart from the proposed mechanism for postdilation IOP elevation in eyes with open angle, mydriasis could induce IOP elevation in angle-closure eyes through a relative pupillary block and increased iridotrabecular contact related to iris crowding. [ 48 50 ] Conversely, cycloplegics lead to the relaxation of the ciliary muscle and posterior displacement of the lens diagram, which deepens the depth of the anterior chamber.…”

Section: Cycloplegics and Intraocular Pressure Changesmentioning

confidence: 99%

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Impact of atropine use for myopia control on intraocular pressure in children: A comprehensive review including postpupil dilation intraocular pressure changes

Chen,

Hsia,

Tsai

et al. 2024

Taiwan Journal of Ophthalmology

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Topical atropine has been widely used for controlling myopia progression in children, yet its long-term efficacy and safety, including potential intraocular pressure (IOP) elevation, are still being studied. The mydriasis and cyclopegia induced by atropine may reduce traction on the trabecular meshwork, together with pigment released into anterior chamber due to the friction between the iris and lens during pupil dilation, may obstruct and reduce the trabecular outflow. This review first explores postdilation IOP changes across different groups – healthy individuals, glaucoma patients, and children. The response to pupil dilation varies widely, with IOP potentially increasing or decreasing. Glaucoma patients, whether with open or closed-angle glaucoma, may experience more significant IOP rises postdilation. The second section examines IOP effects in children using topical atropine for myopia, where most of the 25 reviewed studies showed nonsignificant IOP changes, although slight increases were observed in a few. In addition, no alterations in the retinal nerve fiber layer thickness were found. However, the research on children’s IOP under topical atropine is constrained by small sample sizes, cross-sectional studies, brief follow-ups, and often lacks control groups or pretreatment IOP measurements. Given the extended atropine use for myopia and the significant individual variation in IOP response, we recommend routine IOP monitoring for children receiving topical atropine.

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