The Effects of Systemic Alpha-1 Adrenergic Antagonists on Pupil Diameter in Rats

Altan-Yaycıoğlu, Rana; Yaycıoğlu, Özgür; Tufan, Hale; Akova, Yonca A.; Özkardeş, Hakan

doi:10.1080/02713680601174173

Cited by 5 publications

(2 citation statements)

References 17 publications

(13 reference statements)

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“…A second contributing factor toward greater pupil diameter is upregulation of adrenergic receptors in response to drug exposure. This idea was proposed in a study with rats exposed to 1 month of tamsulosin treatment followed by 1 month of washout 12 . It theoretized the maintenance of upregulated α 1a -AR washout in order to explain dilated pupil diameters of rats that were, albeit statistically insignificant, larger at washout than baseline when dilated with an alpha agonist but not with another mydriatic agent.…”

Section: Discussionmentioning

confidence: 99%

Anterior segment optical coherence tomography changes with introduction and discontinuation of tamsulosin

Alkharashi

Azimzadeh

Leung

et al. 2016

Saudi Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Anterior segment optical coherence tomography changes with introduction and discontinuation of tamsulosin

Alkharashi

Azimzadeh

Leung

et al. 2016

Saudi Journal of Ophthalmology

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“…Buna yönelik Altan Yaycıoğlu ve ark. 'nın (49,50) pupil çaplarının değerlendirildiği çalışmasında olduğu gibi alfa bloker tedavisi alan hastalarda GİS gelişimini ve/veya şiddetini preoperatif öngörmeye yönelik diğer çalışmalarda da tatmin edici sonuçlar alınamamıştır (25). Ayrıca bu bilgilerle beraber GİS'in farkındalığına da değinmek gerekir.…”

Section: Prevelans Ve Etiyolojiunclassified

Alpha Blocker Treatment and Intra-operative Floppy Iris Syndrome

Özyalvaçlı¹,

Doğan²,

Gücük³

2015

uob

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İlerleyen yaşta alt üriner sistem semptomlarının (AÜSS) en sık nedenini benign prostat hiperplazisi (BPH) oluşturmaktadır. Üroloji kılavuzlarının da önerdiği alfa blokör tedavisi BPH'ye bağlı AÜSS'nin temel tedavi modalitesini oluşturmaktadır. Alfa-1 reseptörün alfa-1A, alfa-1B ve alfa-1D olmak üzere üç çeşit alt tipi bulunmaktadır. Alfa blokörlerin %98'i prostat stromal elemanları ile ilişkilidir ve özellikle prostattaki alfa-1 reseptörlerinin yaklaşık %70'i alfa-1A reseptörleridir. Bu reseptörler prostat, mesane boynu ve üretral düz kasların kasılmasından sorumludur. Baş dönmesi, yorgunluk, ortostatik hipotansiyon, senkop, nazal konjesyon ve retrograd ejakülasyon alfa blokör tedavisinin yan etkilerindendir. İntra-operatif gevşek iris sendromu (GİS) ise ilk olarak selektif alfa-1A reseptör blokörü olan tamsulosin kullanan hastaların katarakt cerrahisi sırasında geliştiği belirtilen ve kalıcı görme kaybına yol açabilen bir sendromdur. GİS'in her ne kadar başlangıçta tamsulosin ile ilişkili olduğu belirtilmişse de son yıllarda yapılan çalışmalarda diğer alfa blokörlerin de GİS'e neden olduğu saptanmıştır. GİS'in patofizyolojisi net olarak ortaya konulabilmiş değildir. Özellikle alfa blokör kullanımından saatler sonra bile ortaya çıkabilen bu sendrom alfa blokör kesilmesinden yıllar sonra da ortaya çıkabilmektedir. Bu yazıda, alfa blokör kullanımına bağlı gelişen ve halen etiyolojisi net olarak ortaya konulamayan gevşek iris sendromu ve bu sendromun gelişmesini minimalize etmek için yapılması gerekenler literatür eşliğinde değerlendirilmiştir. Ahahtar Kelimeler: Benign prostat hiperplazisi, alfa blokör, gevşek iris sendromu Benign prostate hyperplasia (BPH) in the leading cause of lower urinary tract symptoms (LUTS) in elderly ages. Alpha blocker treatment which is advised by urology guidelines is the main treatment of LUTS related to BPH. Alpha-1 receptor has three different subtypes including alpha-1A, alpha-1B and alpha-1D. About 98% of alpha blockers are related with prostate stromal elements and 70% of the alpha receptors are alpha-1A receptors. These receptors are responsible for contraction of prostate, bladder and urethral smooth muscles. Dizziness, fatigue, orthostatic hypotension, syncope, nasal congestion, and retrograde ejaculation are the common adverse effects of alpha blockers. Intra-operative floppy iris syndrome (IFIS), which may cause irreversible blindness, was firstly defined in patients treated with tamsulosin (an alpha-1A receptor blocker) during cataract surgery. Afterwards, it has also been shown that other alpha blockers may also cause IFIS. Pathophysiology of IFIS has not been clearly defined. This clinical picture may occur within hours after alpha blocker treatment or it may develop many years after cessation of the treatment. This paper reviews the literature and presents alpha blocker related IFIS and preventive measurements to minimalise the development of IFIS. Keywords: Benign prostatic hyperplasia, alpha blocker, intra-operative floppy iris syndrome Summary ÖzDerleme / Review

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The effects of two systemic α1-adrenergic blockers on pupil diameter: a prospective randomized single-blind study

Altan-Yaycıoğlu

Yaycıoğlu

Gül

et al. 2007

Naunyn-Schmied Arch Pharmacol

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Our aim was to investigate the effects of two alpha(1)-adrenergic blockers-tamsulosin and alfuzosin-on pupil diameter (PD). In this prospective randomized single-blind clinical trial, 64 patients with benign prostatic hyperplasia received treatment with either tamsulosin or alfuzosin. The same ophthalmologist, masked to the given medication, evaluated patients prior to, 4 weeks after and 6 months after the start of the medication (day 0, day 28 and month 6). Best corrected visual acuity and PD under mesopic, scotopic, and dilated conditions were measured. t-test, ANOVA, and Dunnett's multiple comparison post-test were used for statistical analysis. With tamsulosin treatment, both mesopic and scotopic PD decreased, respectively, from 3.9 +/- 0.7 and 5.7 +/- 0.6 mm at day 0 to 3.6 +/- 0.9 and 5.5 +/- 0.8 mm at day 28, and 3.6 +/- 0.7 and 5.4 +/- 0.7 mm at month 6 (ANOVA; P = 0.021 and = 0.040, respectively). However, the difference in dilated PD was not significant (day 0 7.8 +/- 0.6 mm, day 28 7.7 +/- 0.7 mm, and month 6 7.6 +/- 0.6 mm, P = 0.379). In the alfuzosin group, PD did not differ significantly from the baseline except for the scotopic measurements, which decreased from 5.6 +/- 0.6 mm at day 0 to 5.5 +/- 0.6 mm at day 28 and 5.2 +/- 0.8 mm at month 6 (P = 0.004). Compared to baseline values, small but statistically significant decreases were detected in mesopic and scotopic illumination in patients treated with tamsulosin and in scotopic PD in patients treated with alfuzosin. The clinical significance of these differences needs further evaluation.

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The Effects of Systemic Alpha-1 Adrenergic Antagonists on Pupil Diameter in Rats

Cited by 5 publications

References 17 publications

Anterior segment optical coherence tomography changes with introduction and discontinuation of tamsulosin

Anterior segment optical coherence tomography changes with introduction and discontinuation of tamsulosin

Alpha Blocker Treatment and Intra-operative Floppy Iris Syndrome

The effects of two systemic α1-adrenergic blockers on pupil diameter: a prospective randomized single-blind study

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