Abstract
To investigate the potential effects of chronic exposure to a nasal decongestant and its excipients on ocular tissues using an experimental rat model. Sixty adult male Wistar rats were randomized into six groups. The first two groups were control (serum physiologic) and Otrivine® groups. The remaining four groups received the Otrivine excipients xylometazoline, benzalkonium chloride, sorbitol, and ethylene diamine tetra acetic acid. Medications were applied into both nostrils twice a day for 8 weeks. Before the rats were sacrificed, epithelial staining, the Schirmer test, and intraocular pressure measurements were performed under ketamine/xylasine anesthesia (50 and 5 mg/kg, respectively). Epithelial defects and dry eye were common findings in all study groups. Cataracts developed in two cases clinically. Histopathological evaluation revealed many different pathological alterations in all parts of the ocular tissues such as corneal edema, polypoid proliferation and hyalinization of the vessel wall, cystic formation of the lens, retinal nerve fiber layer degeneration, and corpora amylacea formation of the lacrimal gland. Prolonged usage of the nasal decongestant xylometazoline and its excipients may cause ophthalmic problems such as dry eyes, corneal edema, cataracts, retinal nerve fiber layer, and vascular damage in rats. Although these results were obtained from experimental animals, ophthalmologists should keep in mind the potential ophthalmic adverse effects of this medicine and/or its excipients and exercise caution with drugs containing xylometazoline, ethylene diamine tetra acetic acid, benzalkonium chloride and sorbitol for patients with underlying ocular problems.
Highlights
In daily ophthalmology practice, clinicians encounter young individuals with ophthalmic problems such as cataracts, dry eyes, and vascular and retinal diseases with no explainable etiology
A familiar scenario to most ophthalmologists, two young male patients admitted to our clinic at different times complaining of cataracts with an unusual etiology served as the inspiration for this study
Male Wistar rats aged between 4 and 5 months were obtained from the Experimental Animal Center of Adnan Menderes University (ADU), and all experiments were performed according to the principles and guidelines approved by the ADU Animal Ethical Committee (HADYEK 2013/095)
Summary
Clinicians encounter young individuals with ophthalmic problems such as cataracts, dry eyes, and vascular and retinal diseases with no explainable etiology. It is especially important to investigate the cause especially in young patients because cataracts can be the first sign of an important disease such as diabetes mellitus and patients are generally unaware of systemic problems. Cataract etiology is well known and well understood, it is difficult to evaluate young patients with cataracts without any known cause. For these pa tients, the use of drugs applied locally such as aerosols as well as nasal and eye drops should be investigated as patients often do not consider these drugs worth men tioning to their doctors. Nasal decongestants are associated with the troublesome complication of rhinitis medicamentosa, they are often prescribed to patients and may be available from pharmacies without a prescription
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
