Effect of 0.5% Apraclonidine on Ptosis in Horner Syndrome

Garibaldi, Daniel C.; Hindman, Holly B.; Grant, Michael P.; Iliff, Nicholas T.; Merbs, Shannath L.

doi:10.1097/01.iop.0000196322.05586.6a

Cited by 29 publications

(12 citation statements)

References 13 publications

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“…Because upregulation of the postsynaptic adrenergic receptors may require a certain period after sympathetic denervation, pupil dilation may not be achieved in an acute case [19]. The apraclonidine test can be positive between 1 month and 10 years after sympathetic interruption [7,[20][21][22][23][24][25][26][27]. In our study, we found a high rate of apraclonidine positivity (92.5%) similar to Bremner's study.…”

Section: Discussionsupporting

confidence: 84%

The Evaluation of Patient Demographics, Etiologies and Apraclonidine Test Results in Adult Horner's Syndrome

Karti

Kartı²,

Durmaz

et al. 2021

Preprint

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Purpose: We aimed to demonstrate the patient demographics, etiologies and apraclonidine test results in adult Horner's syndrome Methods: This retrospective study was performed by the analysis of medical data of patients who were given 0.5% apraclonidine test. Patients' past medical history, demographic data, etiologies, accompanying neurological findings, and pharmacological test results were assessed.Results: Forty patients (21 females and 19 males) with a mean age of 50.3 ± 11.6 years were evaluated. Apraclonidine 0.5% test was positive in 37 patients (92.5%). An etiology could be identified in 20 patients (central (9 patients, 45%), preganglionic (9 patients, 45%), and postganglionic (2 patients, 10%)). Neurological findings accompanying Horner’s syndrome were present in 9 patients.Conclusion: Despite detailed investigations, in a significant number of patients with Horner's syndrome an underlying cause may not be detected. Among the identifiable lesions, central and preganglionic involvements are still the first leading causes of Horner's syndrome. In addition, apraclonidine test may not be positive in all patients and a negative response does not exclude Horner's syndrome.

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Section: Discussionsupporting

confidence: 84%

The Evaluation of Patient Demographics, Etiologies and Apraclonidine Test Results in Adult Horner's Syndrome

Karti

Kartı²,

Durmaz

et al. 2021

Preprint

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show abstract

“…Via its α 1 -adrenergic receptor-mediated effects, topical apraclonidine can temporarily reverse anisocoria due to Horner’s syndrome, thus supporting this diagnosis [ 16 ]. A case report also revealed elevation of the upper eyelid in three patients with Horner’s syndrome after instillation of 0.5% apraclonidine [ 67 ]. A larger evaluation of the effect of apraclonidine on upper eyelid elevation was conducted in 100 non-ptotic subjects, demonstrating small mean increases in MRD-1 at 30 and 45 min post-instillation that were hypothesised to be a result of stimulation of postsynaptic α 1 -adrenergic receptors [ 68 ].…”

Section: Acquired Ptosis Treatmentmentioning

confidence: 99%

A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options

Bacharach

Lee

Harrison

et al. 2021

Eye

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Blepharoptosis (ptosis) is among the most common disorders of the upper eyelid encountered in both optometric and ophthalmic practice. The unilateral or bilateral drooping of the upper eyelid that characterises ptosis can affect appearance and impair visual function, both of which can negatively impact quality of life. While there are several known forms of congenital ptosis, acquired ptosis (appearing later in life, due to a variety of causes) is the predominant form of the condition. This review summarises the prevalence, causes, identification, differential diagnosis, and treatment of acquired ptosis. Particular attention is paid to the differential diagnosis of acquired ptosis and emerging treatment options, including surgical and pharmacologic approaches.

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“…Thus, reversal of ptosis with apraclonidine is not useful in diagnosis but may be a consideration for symptomatic relief in patients with Horner's syndrome [63,66].…”

Section: Apraclonidinementioning

confidence: 99%

Horner’s syndrome, Pseudo-Horner’s syndrome, and simple anisocoria

Martin

2007

Curr Neurol Neurosci Rep

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This discussion reviews the common causes of Horner's syndrome, with emphasis on case reports from the past several years. Much of the recent literature concerns the use of apraclonidine as a diagnostic test for Horner's syndrome, possibly as an alternative for the current gold standard of cocaine eye drops. This new literature is discussed in the context of the current standards for clinical diagnosis.

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Effect of 0.5% Apraclonidine on Ptosis in Horner Syndrome

Cited by 29 publications

References 13 publications

The Evaluation of Patient Demographics, Etiologies and Apraclonidine Test Results in Adult Horner's Syndrome

The Evaluation of Patient Demographics, Etiologies and Apraclonidine Test Results in Adult Horner's Syndrome

A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options

Horner’s syndrome, Pseudo-Horner’s syndrome, and simple anisocoria

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