The change in intraocular pressure after pupillary dilation in eyes with pseudoexfoliation glaucoma, primary open angle glaucoma, and eyes of normal subjects
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To evaluate the change in intraocular pressure (IOP) after pharmacologic dilation in eyes with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and eyes of normal subjects. This cross-sectional study was conducted in a university hospital-based setting. Patients with PXG, POAG, and normal subjects were consecutively selected and included in the study. Of the 125 eyes of 125 subjects; 46 (25 female) had PXG, 42 (29 female) had POAG, and 37 (20 female) belonged to the control group. Pharmacologic dilation procedure consisted of instillation of topical phenylephrine HCL 10 % followed 5 min by tropicamide 1 %. Studied variables were pre- and post-dilation IOP and also baseline measurements of anterior chamber angle, central corneal thickness, and pupillary diameter by Pentacam HR (Oculus, Wetzlar, Germany). Clinically significant IOP change was defined as a change of ≥2 mmHg from baseline. Randomly selected single eye of each patient was included in the analysis. The mean pre:post-dilation IOP of eyes with PXG and POAG was 17.39 ± 3.89:17.54 ± 3.98 and 15.92 ± 2.37:16.07 ± 2.89 mmHg, respectively. The difference between the pre- and post-dilation IOP of eyes with PXG and POAG was not statistically significant. The eyes of control subjects, however, had a statistically significant reduction of IOP from 14.24 ± 2.88 to 13.54 ± 2.94 mmHg (P = 0.005). 28.3 % (13/46) of eyes with PXG, 16.7 % (7/42) of eyes with POAG, and 2.7 % (1/37) of control eyes showed a clinically significant IOP elevation from baseline after the dilation. In this study, glaucoma patients proportionally experienced a higher rate of clinically significant IOP elevation after pupillary dilation, when compared to normal subjects.
KeywordsPupillary dilation Mydriasis Pseudoexfoliation glaucoma Primary open angle glaucoma Tropicamide Phenylephrine
The authors have no financial or proprietary interest to disclose.
- 8.Siam GA, de Barros DS, Gheith ME, Da Silva RS, Lankaranian D, Tittler EH, Myers JS, Spaeth GL (2007) The amount of intraocular pressure rise during pharmacological pupillary dilatation is an indicator of the likelihood of future progression of glaucoma. Br J Ophthalmol 91:1170–1172CrossRefPubMedCentralPubMedGoogle Scholar
- 12.Musch DC, Gillespie BW, Niziol LM, Cashwell LF, Lichter PR, on behalf of the CIGTS Study Group (2008) Factors Associated with Intraocular Pressure Prior to and during 9 years of Treatment in the Collaborative Initial Glaucoma Treatment Study. Ophthalmology 115:927–933CrossRefPubMedCentralPubMedGoogle Scholar
- 13.Weinreb RN, Brandt JD, Garway-Heath DF, Medeiros FA, Brandt J, Liu J (2007) IOP as a risk factor for glaucoma development and progression. In: Weinreb RN, Brandt JD, Garway-Heath DF, et al. (eds) Intraocular pressure: reports and consensus statements of the 4th Global AIGS Consensus meeting on intraocular pressure. WGA Consensus Series 4. Kugler, The Hague, p 59–74Google Scholar