A comparison of the pupillary and cardiovascular effects of various mydriatic agents in preterm infants

B. D. Sindel, M. D. Baker, M. J. Maisels, J. Weinstein

Research output: Contribution to journalArticle

Abstract

We conducted a randomized, masked study of pupillary dilating capabilities and associated cardiovascular effects of three solutions. Thirty-four babies < 1500 grams at birth were studied at six to eight weeks. Group A (n = 10) received phenylephrine (PE) 2.5% and tropicamide 1.0%; Group B (n = 10) PE 2.5%, tropicamide 0.5%, and cyclopentolate 0.5%, Group C (n = 10) PE 1.0% and tropicamide 1.0%; Group D (n = 4) saline 0.9%. One drop was placed in each eye and repeated five minutes later. Pupillary dilation was measured with a metric ruler by direct observation at one hour. Blood pressure (BP) and heart rate (HR) were monitored, using an oscillometer, immediately prior to the instillation of the drops and at five-minute intervals, for 60 minutes. BP and HR increased transiently in all groups receiving mydriatics but returned to baseline values in 25 minutes. This increase was significant in Groups A and B (2.5% PE: p < 0.02). Group D (saline) showed no change in BP or HR. Postdrop pupillary size was largest in Group A but the differences were not significant. On exposure to birght light, the pupillary size in Group C was significantly smaller than Groups A or B (7.35 ± 0.59 mm, 7.23 ± 0.38 mm and 6.75 ± 0.57 mm in Groups A, B and C, p < .01). Neveretheless, dilation was sufficient to allow appropriate examination in all infants (pupillary diameter > 6.0 mm). Solutions containing 2.5% PE are most effective for use in LBW infants, but produce cardiovascular effects. Solutions containing 1% PE provide adequate dilation with minimum cardiovascular effects.

Original languageEnglish (US)
Pages (from-to)273-276
Number of pages4
JournalJournal of pediatric ophthalmology and strabismus
Volume23
Issue number6
StatePublished - Dec 1 1986
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

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