Effects of different mydriatics on the choroidal vascularity in healthy subjects

Iovino, Claudio; Chhablani, Jay; Rasheed, Mohammed Abdul; Tatti, Filippo; Bernabei, Federico; Pellegrini, Marco; Giannaccare, Giuseppe; Peiretti, Enrico

doi:10.1038/s41433-020-0995-9

Cited by 11 publications

(13 citation statements)

References 29 publications

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“…Two studies found that SFCT significantly decreased from baseline after administration of tropicamide 1% 7,21 . Two different studies did not find a significant change in SFCT 40–45 minutes after administration of topical tropicamide 1% 9,22 or a combination of topical tropicamide 0.5% and phenylephrine 10% 9 . Also, no change in choroidal vascularity index was observed after the administration of tropicamide or coadministration of tropicamide and phenylephrine 9 .…”

Section: Resultsmentioning

confidence: 98%

“…9 Also, no change in choroidal vascularity index was observed after the administration of tropicamide or coadministration of tropicamide and phenylephrine. 9 SFCT and parafoveal CT were significantly increased 30 and 60 minutes after 2% homatropine administration. 8 A week of twice daily administration of 1% atropine ophthalmic gel led to a significant increase in subfoveal and parafoveal CT. 18 Two additional studies investigating the effect of 1% atropine have found similar findings of increased CT. 19,20 The study by Jiang et al 20 suggests that the recovery period of CT back to baseline after atropine withdrawal may take up to 7 weeks.…”

Section: Topical Mydriatics/cycloplegicsmentioning

confidence: 91%

“…7,21 Two different studies did not find a significant change in SFCT 40-45 minutes after administration of topical tropicamide 1% 9,22 or a combination of topical tropicamide 0.5% and phenylephrine 10%. 9 Also, no change in choroidal vascularity index was observed after the administration of tropicamide or coadministration of tropicamide and phenylephrine. 9 SFCT and parafoveal CT were significantly increased 30 and 60 minutes after 2% homatropine administration.…”

Section: Topical Mydriatics/cycloplegicsmentioning

confidence: 95%

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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: 98%

Section: Topical Mydriatics/cycloplegicsmentioning

confidence: 91%

Section: Topical Mydriatics/cycloplegicsmentioning

confidence: 95%

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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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“…Tropicamide was instilled before pre-dive measures, therefore there was no influence in comparison between pre- and post-dive values. Iovino et al published in 2020 that there was no significant difference in SFCT before or after mydriatic instillation [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of SCUBA Diving on Ophthalmic Parameters

et al. 2022

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Background and Objective: Several cases of central serous chorioretinopathy (CSC) in divers have been reported in our medical retina center over the past few years. This study was designed to evaluate possible changes induced by SCUBA diving in ophthalmic parameters and especially subfoveal choroidal thickness (SFCT), since the choroid seems to play a crucial role in physiopathology of CSC. Materials and Methods: Intraocular pressure (IOP), SFCT, pachymetry, flow-mediated dilation (FMD), blood pressure, and heart rate were measured in 15 healthy volunteer divers before diving, 30 and 60 min after a standard deep dive of 25 m depth for 25 min in a dedicated diving pool (NEMO 33). Results: SFCT reduces significantly to 96.63 ± 13.89% of pre-dive values (p = 0.016) 30 min after diving. It recovers after 60 min reaching control values. IOP decreases to 88.05 ± 10.04% of pre-dive value at 30 min, then increases to 91.42 ± 10.35% of its pre-dive value (both p < 0.0001). Pachymetry shows a slight variation, but is significantly increased to 101.63 ± 1.01% (p = 0.0159) of the pre-dive value, and returns to control level after 60 min. FMD pre-dive was 107 ± 6.7% (p < 0.0001), but post-dive showed a diminished increase to 103 ± 6.5% (p = 0.0132). The pre-post difference was significant (p = 0.03). Conclusion: Endothelial dysfunction leading to arterial stiffness after diving may explain the reduced SFCT observed, but SCUBA diving seems to have miscellaneous consequences on eye parameters. Despite this clear influence on SFCT, no clear relationship between CSC and SCUBA diving can be drawn.

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“…The CVI was calculated using the previously reported automated algorithm that included initial denoising with localization of the choroidal inner and outer boundaries [15][16][17]. To allow computation of the luminal choroidal area (LCA) and stromal choroidal area (SCA), the OCT B-scan passing through the fovea was binarized and choroidal components were segmented.…”

Section: Oct Analysis Of the Retina And Choroidmentioning

confidence: 99%

Choroidal Vascularity Features in Patients with Choroideremia and Cystoid Spaces

et al. 2021

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Cystoid spaces (CSs) are a common retinal finding in choroideremia (CHM) patients. The aim of this study was to analyze the vascular features of the choroid associated with the presence of CSs in patients with confirmed genetic diagnosis of CHM. A total of 33 patients (33 eyes) were enrolled in this retrospective cross-sectional study and divided into two groups based on the presence (17 eyes) or absence (16 eyes) of CSs. Choroidal features were evaluated on spectral-domain optical coherence tomography including subfoveal choroidal thickness (CT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA). The choroidal vascularity index (CVI) was then calculated in all study eyes. All structural choroidal parameters were calculated both on the entire length of the B-scan and in the central subfoveal 1500 μm. The average age was 37.3 ± 11.6 and 31.4 ± 16.7 years (p = 0.25) and mean logMAR best-corrected visual acuity was 0.11 ± 0.20 and 0.20 ± 0.57 (p = 0.54) in the CHM groups with and without CSs, respectively. There were no significant differences in subfoveal CT, and TCA, LCA, SCA, and CVI evaluated on either the entire scan or in the central 1500 μm (all p > 0.05). All choroidal vasculature parameters exhibited no significant differences between CHM eyes with and without CSs. Our results suggest that the choroid may not be involved in the development of CSs in patients with CHM.

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Effects of different mydriatics on the choroidal vascularity in healthy subjects

Cited by 11 publications

References 29 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

Effect of SCUBA Diving on Ophthalmic Parameters

Choroidal Vascularity Features in Patients with Choroideremia and Cystoid Spaces

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