Effects Of Cyclopentolate Research Articles

Ocular and Dental Causes of Headaches Among School-Age Children in Jordan: A Retrospective Study.

IntroductionHeadache disorders are becoming increasingly prevalent among the younger population. In this study, we aimed to explore the varying causes of headaches among school-age children in Jordan.MethodologyThis was a retrospective observational study conducted at the Queen Rania Hospital for Children between June 2019 and June 2020. All the data of the patients were extracted from the patient files with the permission of the administration. All children who were referred to the ophthalmology and dental clinic with headaches as the presenting complaint were included in the study. A detailed history was initially obtained regarding age, gender, medical history, as well as the duration and characteristics of headaches. The patients underwent detailed ocular examination including best-corrected visual acuity (BCVA) using the Snellen chart, anterior and posterior eye segment examination, and intraocular pressure measurement. Refraction under the effect of cyclopentolate was performed for all patients. A detailed dental and oral exam was performed on all children at the dental clinic by the same dentist.ResultsA total of 712 patients aged between five and 13 years (mean ± SD: 9.3 ± 2.86 years) presented with headaches during the study period. Headaches were more frequent in males [n=441 (61.9%)], but a slight female predominance was found among patients aged 11 years and older. At the ophthalmology clinic, 230 (32.3%) patients with headaches had positive findings; the majority of these patients [n=228 (32%)] had refractive errors with astigmatism as the most common type. Of note, 515 patients (72.3%) had dental caries with a Decayed, Missing, and Filled Permanent Teeth (DMFT) score ranging from 1.5 to 4.3.ConclusionRefractive errors, particularly astigmatism, were found at higher rates among children with headaches. Also, temporomandibular disorders were more prevalent among children with headaches, particularly those aged between 11 and 14 years. Routine ophthalmic and dental assessment is recommended for children presenting with chronic headaches.

Effects of Cyclopentolate on Form Deprivation Myopia in Guinea Pigs

Purpose: To investigate the effects of intravitreal injection of cyclopentolate on form deprivation myopia in guinea pigs. Methods: Thirty-five guinea pigs at age of 3 weeks were randomly divided into 5 groups (n = 7 for each group): deprived, deprived plus saline, deprived plus cyclopentolate, normal control, and cyclopentolate group. Form deprivation was only performed in right eyes with translucent membranes for 4 weeks. Physiological saline and cyclopentolate were intravitreally injected into deprived eyes at four-day intervals. All the left eyes remained untreated as group control. Refraction was measured by retinoscopy after cycloplegia. The axial dimensions were measured by A-scan ultrasound. Subsequently, retinal histology was observed by light microscopy. Results: After 4 weeks of treatment, intravitreal injection of cyclopentolate significantly reduced the degree of myopia in the deprived eyes (from -3.92 D to -0.86 D, P < 0.001), and retarded the increase of vitreous chamber depth (from 3.83 ± 0.06 mm to 3.70 ± 0.05 mm, P < 0.001) and axial length (from 8.42 ± 0.04 mm to 8.30 ± 0.05 mm, P < 0.001) in the deprived eyes. Histological ex-amination revealed no evidence of retinal damage of eyes injected with physiological saline or cy-clopentolate compared with normal control eyes. Conclusions: Intravitreal administration of cy-clopentolate reduces axial elongation of the deprived eyes in guinea pigs. Further investigations are required to identify the optimal dose.

A Prospective Comparison Between Cyclopentolate Spray and Drops in Pediatric Outpatients

To determine whether children tolerate cyclopentolate 1% spray better than drops and to assess the adequacy of cycloplegia achieved by spray for objective refraction. The effects of cyclopentolate 1% drops and spray on distress levels were assessed prospectively using a guardian questionnaire in consecutive patients 10 years of age or younger. Distress was graded at various points during the appointment using a Likert scale of 1 to 10 (1 = no distress, 10 = severe distress). The adequacy of cycloplegia in children receiving cyclopentolate spray and the waiting times were assessed via a Likert questionnaire completed by the examining physician. The guardians of 72 and 77 children who received cyclopentolate 1% drops or spray, respectively, completed the questionnaire. The children were divided in three age groups: 1 to 4 years, 5 to 7 years, and 8 to 10 years. Children 7 years or younger were significantly less distressed by administration of cyclopentolate 1% spray (P < .005). There was no statistical difference in distress levels in children older than 7 years (P = .9719). Thirteen of the 77 children who received cyclopentolate 1% spray did not have adequate cycloplegia to allow objective refraction. The results demonstrate cyclopentolate 1% spray is less distressing at the time of administration than cyclopentolate 1% drops for children 7 years or younger. However, the cycloplegia achieved is not adequate in a high percentage of children.

The Effects of Cyclopentolate on Intraocular Pressure and Retrobulbar Hemodynamics in Patients with Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

Purpose To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Methods Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. Results Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p=0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p=0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p&lt;0.05) and RI of the posterior ciliary artery increased significantly (p=0.01) after cyclopentolate instillation. Conclusions On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells.

The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma.

To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p=0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p=0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p<0.05) and RI of the posterior ciliary artery increased significantly (p=0.01) after cyclopentolate instillation. On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells. (Eur J Ophthalmol 2004; 14: #-400).

Changes in intraocular pressure following diagnostic mydriasis with cyclopentolate 1%.

To assess the effect of diagnostic mydriasis with 1% cyclopentolate on the intraocular pressure (IOP) of patients attending glaucoma, medical retina and cataract clinics. Levels of agreement for IOP assessment were determined and 95% of repeated readings found to be within +/-2 mmHg. The IOP of 83 cataract, 87 medical retinal and 100 glaucoma patients was measured with Goldmann applanation tonometry before and 45 min after dilatation with 1% cyclopentolate. Those showing a substantial (>10 mmHg) increase in IOP underwent gonioscopy to determine if their angles remained open and were medically treated to lower their IOP. An approximately normal distribution of change in IOP following dilatation was seen in all three groups (mean change 0.4 mmHg (95% CI 0.1-0.8)). The proportion of patients with a rise of 5 mmHg or more in the right eye was 7% (95% CI 4-10%). Logistic regression using all right eyes, looking at age, sex, diagnosis, ethnicity, ocular medication, iris colour and lens status (phakic/pseudophakic/aphakic) as risk factors for a rise of IOP of 5 mmHg or more did not reveal any significant contribution. Correlation between results obtained for right and left eyes in the glaucoma group was lower (0.43) than for the other groups (0.66 and 0.72), but the extent to which the direction of change in one eye predicted that in the other was shown to be high. Two glaucoma patients with open angles developed a clinically important (>10 mmHg) sustained rise in IOP requiring treatment. Individual variability in the effects of cyclopentolate on aqueous dynamics may account for the approximately normal distribution of IOP seen following dilatation in all three groups. This variation was in excess of that due to observation error alone. It is recommended that the IOP be rechecked after dilation in glaucoma patients with significantly damaged optic nerve heads. In medical retina and cataract patients, sustained clinically important rises in intraocular pressure following dilation seem rarer.

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. I. Effect on intraocular pressure.

The mydriasis provocative test with 1% cyclopentolate (CPT) was performed on 218 patients with suspected or untreated open-angle glaucoma, on 431 eyes in all. Gonioscopy was performed before and during the test to ensure that te chamber angles were open throughout. The effect of cyclopentolate on intraocular pressure (10P) in these eyes is reported in the present paper. The mean change in IOP (+/-SD) During CPT was +2.5 +/- 3.1 mmHg in the glaucoma group (196 eyes), +0.4 +/- 2.5 mmHg in the group with suspicion of open-angle glaucoma (235 eyes), and +1.4 +/- 2.9 mmHg in the total series. The difference in IOP change between the groups with glaucoma and suspected glaucoma is statistically highly significant. The incidence of positive responses (IOP rise larger than or equal to 8 mmHg) in the glaucoma group (8.7%: 17 eyes) was significantly higher than in the suspicion group (1.7%: 4 eyes). Significant IOP elevations in the total series were demonstrated in 21 eyes of 18 patients (4.9%). Including the borderline cases, IOP elevations larger than or equal to 5 mmHg were also significantly more frequent in eyes with glaucoma (24.0%: 47 eyes) than in eyes with suspected glaucoma (11.9%: 28 eyes). The occurrence and magnitude of positive responses were not dependent on the initial IOP level. Further analysis of the responder group and clinical studies of the mechanism of IOP elevation on the same patients are presented in parts II and III.

Effect of Cyclopentolate on the Aqueous Dynamics of Iridectomized Eyes: Follow-up of prophylactic peripheral iridectomy

Effect of Cyclopentolate on the Aqueous Dynamics of Iridectomized Eyes: Follow-up of prophylactic peripheral iridectomy