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Eye & Contact Lens Jan 2016Slowing the progression of myopia has become a considerable concern for parents of myopic children. At the same time, clinical science is rapidly advancing the knowledge... (Review)
Review
Slowing the progression of myopia has become a considerable concern for parents of myopic children. At the same time, clinical science is rapidly advancing the knowledge about methods to slow myopia progression. This article reviews the peer-reviewed literature regarding several modalities attempting to control myopia progression. Several strategies have been shown to be ineffective for myopia control, including undercorrection of myopic refractive error, alignment fit gas-permeable contact lenses, outdoor time, and bifocal of multifocal spectacles. However, a recent randomized clinical trial fitted progressing myopic children with executive bifocals for 3 years and found a 39% slowing of myopia progression for bifocal-only spectacles and 50% treatment effect for bifocal spectacles with base-in prism, although there was not a significant difference in progression between the bifocal-only and bifocal plus prism groups. Interestingly, outdoor time has shown to be effective for reducing the onset of myopia but not for slowing the progression of myopic refractive error. More effective methods of myopia control include orthokeratology, soft bifocal contact lenses, and antimuscarinic agents. Orthokeratology and soft bifocal contact lenses are both thought to provide myopic blur to the retina, which acts as a putative cue to slow myopic eye growth. Each of these myopia control methods provides, on average, slightly less than 50% slowing of myopia progression. All studies have shown clinically meaningful slowing of myopia progression, including several randomized clinical trials. The most investigated antimuscarinic agents include pirenzepine and atropine. Pirenzepine slows myopia progression by approximately 40%, but it is not commercially available in the United States. Atropine provides the best myopia control, but the cycloplegic and mydriatic side effects render it a rarely prescribed myopia control agent in the United States. However, low-concentration atropine has been shown to provide effective myopia control with far fewer side effects than 1.0% atropine. Finally, two agents, low-concentration atropine and outdoor time have been shown to reduce the likelihood of myopia onset. Over the past few years, much has been learned about how to slow the progression of nearsightedness in children, but we still have a lot to learn.
Topics: Child; Child, Preschool; Contact Lenses, Hydrophilic; Disease Progression; Eyeglasses; Humans; Leisure Activities; Muscarinic Antagonists; Mydriatics; Myopia; Refractive Errors
PubMed: 26513719
DOI: 10.1097/ICL.0000000000000207 -
The Practitioner Nov 1960
Topics: Mydriatics
PubMed: 13785303
DOI: No ID Found -
Photodiagnosis and Photodynamic Therapy Sep 2022This report aimed to determine if pupil-dilating eye drops (mydriatics) affected serous pigment epithelial detachment elevation in an eye with central serous...
This report aimed to determine if pupil-dilating eye drops (mydriatics) affected serous pigment epithelial detachment elevation in an eye with central serous chorioretinopathy using spectral domain-optical coherence tomography. A 47-year-old man presented to our clinic with metamorphopsia in his right eye, which had best corrected visual acuity of 20/20. Spectral domain-optical coherence tomography revealed minimal subretinal fluid and serous pigment epithelial detachment. During the follow-up examination after the final diagnosis of central serous chorioretinopathy and serous pigment epithelial detachment, different pigment epithelial detachment elevations on optical coherence tomography images before and after pupil dilation were found incidentally. These elevations were re-measured separately on different days before and after pupil dilation with 2.5% phenylephrine and 1% tropicamide to determine if this was a mydriatic-induced increase in pigment epithelial detachment elevation, which was eventually found to be the case. Mydriatics appeared to affect pigment epithelial detachment elevation in central serous chorioretinopathy. A thorough consideration of pre-dilation ocular examination and imaging data in central serous chorioretinopathy may be valuable.
Topics: Central Serous Chorioretinopathy; Fluorescein Angiography; Humans; Male; Middle Aged; Mydriatics; Photochemotherapy; Retinal Detachment; Tomography, Optical Coherence
PubMed: 35472641
DOI: 10.1016/j.pdpdt.2022.102877 -
Eye (London, England) Mar 2021To evaluate choroidal vasculature changes after the instillation of mydriatic parasympatholytic and sympathomimetic agents in healthy subjects. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To evaluate choroidal vasculature changes after the instillation of mydriatic parasympatholytic and sympathomimetic agents in healthy subjects.
METHODS
A total of 95 healthy subjects were enrolled in this prospective, randomized comparative study. Study participants were divided into three different groups depending on the drug to be administered: tropicamide (1%) group (n = 31), tropicamide (0.5%) + phenylephrine (10%) group (n = 30) and control group receiving artificial tears (n = 34). All participants underwent a complete ophthalmological examination including best corrected visual acuity, refractive status and axial length. Subfoveal choroidal thickness (CT), total choroidal area (TCA), luminal and stromal choroidal area (LCA and SCA) and choroidal vascularity index (CVI) were measured before and after eye drops instillation.
RESULTS
All the baseline characteristics were matched between the three groups (all P > 0.05). Before the mydriatic instillation, there were no significant differences of CT, TCA, LA, SCA, and CVI among the three groups (all P > 0.05). After drug administration, CT, TCA, LCA, SCA, and CVI did not show any significant change as well (respectively, P = 0.265; P = 0.483; 0.573; P = 0.405 and P = 0.708).
CONCLUSIONS
Instillation of mydriatic eye drops did not induce significant changes of the choroidal vasculature, suggesting that their use do not alter CT and CVI evaluation.
Topics: Choroid; Healthy Volunteers; Humans; Mydriatics; Prospective Studies; Tomography, Optical Coherence
PubMed: 32467635
DOI: 10.1038/s41433-020-0995-9 -
Drug Development and Industrial Pharmacy Sep 2017The aim of the present paper was the development of semi-solid (hydrogels) and solid (film) ophthalmic formulations for the controlled release of two mydriatics:...
The aim of the present paper was the development of semi-solid (hydrogels) and solid (film) ophthalmic formulations for the controlled release of two mydriatics: phenylephrine and tropicamide. The formulations - based on polyvinylalcohol and hyaluronic acid - were characterized, and release studies were performed with three different in vitro set-ups, i.e. Franz-type diffusion cell, vial method and inclined plane; for comparison, a solution and a commercial insert, both clinically used to induce mydriasis, were evaluated. Both gels and film allowed for a controlled release of drugs, appearing a useful alternative for mydriatics administration. However, the release kinetic was significantly influenced by the method used, highlighting the need for optimization and standardization of in vitro models for the evaluation of drug release from ophthalmic dosage forms.
Topics: Chemistry, Pharmaceutical; Drug Combinations; Eye; Humans; In Vitro Techniques; Mydriatics; Ophthalmic Solutions; Phenylephrine; Pupil; Tropicamide
PubMed: 28426341
DOI: 10.1080/03639045.2017.1318910 -
British Medical Journal Nov 1965
Topics: Adult; Ethnology; Glaucoma; Humans; Iris; Mydriatics; Pigmentation
PubMed: 5833615
DOI: No ID Found -
Pediatrics International : Official... Feb 2020
Topics: Constriction, Pathologic; Drug Combinations; Enterocolitis, Necrotizing; Humans; Infant, Extremely Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases; Male; Mydriatics; Phenylephrine; Retinopathy of Prematurity; Treatment Outcome; Tropicamide; Vision Tests
PubMed: 32104987
DOI: 10.1111/ped.14073 -
Current Eye Research Jun 1991Three soft drug analogs of atropine have been tested for mydriatic activity in rabbits' eyes and their in vitro metabolic pathway has been investigated in rat, rabbit... (Comparative Study)
Comparative Study
Three soft drug analogs of atropine have been tested for mydriatic activity in rabbits' eyes and their in vitro metabolic pathway has been investigated in rat, rabbit and human blood. The three soft drugs were found to produce an equieffective mydriatic activity to atropine and tropicamide. At equieffective concentrations, their durations were shorter with AUC's 12-21% that of 0.25% atropine and 44-80% that of 0.2% tropicamide. The untreated control eyes were observed to dilate after unilateral ocular administration of atropine, but not with unilateral soft drug treatment. In vitro stability studies showed that the soft ethyl analog was less stable in rat blood and rat liver homogenate than in rabbit or human blood. The metabolic product of the soft ethyl derivative in biological media was proven to be the corresponding inactive acidic metabolite predicted by the soft drug design. The ultrashort durations and the potentially nontoxic systemic properties of the soft mydriatics offer promise for use in ophthalmoscopy and in other ocular procedures where a short acting anticholinergic type of mydriatic would be indicated.
Topics: Animals; Atropine Derivatives; Chromatography, High Pressure Liquid; Drug Stability; Female; Humans; Liver; Male; Mydriatics; Rabbits; Rats; Reflex, Pupillary
PubMed: 1893772
DOI: 10.3109/02713689109001765 -
The Practitioner Jun 1961
Topics: Muscle Relaxants, Central; Mydriatics
PubMed: 13789592
DOI: No ID Found -
The Journal of Pediatrics Sep 2000Preterm infants are more likely to have episodes of abdominal distention, emesis, and gastric residuals 24 hours after their first screening examination for retinopathy...
OBJECTIVE
Preterm infants are more likely to have episodes of abdominal distention, emesis, and gastric residuals 24 hours after their first screening examination for retinopathy of prematurity (ROP) than on the day preceding the examination. Because these feeding problems reflect abnormalities in motor function, the purpose of this study was to compare antral and duodenal motor activity and gastric emptying in preterm infants before and after the instillation of mydriatics.
STUDY DESIGN
Using a low compliance continuous perfusion manometric system, we recorded antral and duodenal fasting motor activity in 11 preterm infants before and after the instillation of mydriatics for their first screening examination for ROP. Gastric emptying was compared before and after the eye examination.
RESULTS
Although the number of antral motor contractions remained relatively constant throughout the study, duodenal motor contractions decreased nearly fourfold after the instillation of mydriatics versus that seen before (P <.01). Gastric emptying was significantly delayed after the completion of the eye examination compared with that seen before the examination (P <.05).
CONCLUSION
Current doses of mydriatics inhibit duodenal motor activity and delay gastric emptying, and these gastrointestinal effects of mydriatics may underlie the feeding difficulties seen in preterm infants on the day of screening examinations for ROP.
Topics: Duodenum; Gastric Emptying; Gastrointestinal Motility; Humans; Infant, Newborn; Infant, Premature; Mydriatics; Pyloric Antrum; Retinopathy of Prematurity; Retrospective Studies
PubMed: 10969255
DOI: 10.1067/mpd.2000.107842