Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Derinöz, Okşan; Er, Anıl

doi:10.1097/pec.0b013e3182417a63

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Our results in this animal model lend further support to previously reported post-administration feeding intolerance in clinical setting [10,13,14,15,16,20,21,22,23]. Findings from our study show that ophthalmic cyclopentolate administration produces detectable and measurable concentrations in serum samples from neonatal mice.…”

Section: Discussionsupporting

confidence: 80%

“…Multiple studies have found that mydriatic drops may cause systemic side effects in neonates, ranging from cardiovascular to enteric manifestations [11,12,13,14,15,16,17,18,19,20,21,22,23,24]. Those with lower body weights are especially prone to these sequelae [25], which may include flushing, tachycardia and increases in blood pressure, along with hallucinations, seizure activity, abdominal distension and feeding intolerance [11,12,13,14,15,16,17,18,19,20,21,22,23,24,26]. Because cyclopentolate readily crosses the blood-brain barrier, physostigmine remains the antidote of the choice [27].…”

Section: Introductionmentioning

confidence: 99%

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Systemic Effects of Ophthalmic Cyclopentolate on Body Weight in Neonatal Mice

et al. 2014

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Background: Cyclopentolate is standardly used in ophthalmologic examinations of neonates to facilitate screening for retinopathy of prematurity. Reports of systemic effects have raised concerns of an increased risk of feeding intolerance after the examinations. Objectives: The goal of this study was to evaluate systemic concentrations of cyclopentolate after ophthalmic administration, as well as assess changes in weight as an indirect measure of alteration in feeding. Methods: Neonatal mice were randomized into three groups to simulate a neonatal model for ophthalmic medication administration. The cyclopentolate group received a one-time administration of tetracaine, cyclopentolate, and phenylephrine ophthalmologic solutions in accordance with the protocol used at the children's hospital. The placebo group received the same ophthalmic drop administration, except for normal saline in place of cyclopentolate, and the control group received no ophthalmic drops and minimal handling. Daily weights and serum samples to measure systemic concentrations of cyclopentolate post-ophthalmic administration were assessed at baseline and for 7 days following drop administration. Results: Analysis of serum levels demonstrated detectability of systemic cyclopentolate after ophthalmic administration as early as 30 min (86 ng/ml), 1 h (60 ng/ml), and 24 h (6.2 ng/ml). There were also differences in weight gained on following ophthalmic administration observed between the cyclopentolate group and placebo group, with the cyclopentolate group weighing significantly less on days 3 and 7 (p = 0.02). Conclusions: Results indicate cyclopentolate is absorbed systemically and instillation of cyclopentolate decreases weight gain in neonatal mice compared to placebo. These preclinical findings provide rationale for further studies in neonatal patients.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Systemic Effects of Ophthalmic Cyclopentolate on Body Weight in Neonatal Mice

et al. 2014

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“…Cycloplegic agents have some side effects such as irritation, burning, photophobia. Some adverse reactions, such as concentration and memory problems, confusion, drowsiness, disorientation, and seizures, were reported [9,10]. However, these side effects are temporary and well-tolerated.…”

Section: Discussionmentioning

confidence: 99%

Refractive Outcomes of Table-Mounted and HandheldAuto-Refractometers in Children: An Observational Cross-Sectional Study

Karabulut

Karalezlı

2021

Preprint

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Background: To compare the refractive results of two autorefractors.Methods: We designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated reliability.Results: Nidek HandyRef-K autorefractor measured more astigmatism and myopia in terms of the mean cylindrical power (P<.001) and spherical equivalent (P=.024). Nidek HandyRef-K showed significantly more myopic results in subgroups with spherical power more than +1.50 Diopters (D) hyperopia and -3.00 D myopia (P=.031; P=.045; P=.026; respectively) and higher astigmatism in the subgroup with the cylindric power less than -1.00 D (P<.001). The mean differences and 95% LoA were 0.06 D ± 0.47 D (-0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (-0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (-0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (-0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (-1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. There was a strong correlation for spherical power (Spearman’s rho=0.99, P<.001), cylindrical power (Spearman’s rho=0.88, P<.001), spherical equivalent (Spearman’s rho=0.98, P<.001).Conclusion: Nidek HandyRef-K showed more myopic results regarding spherical equivalent and cylindrical power. Nidek HandyRef-K showed significantly more myopia in spherical power more than +1.50 D hyperopia, -3.00 D myopia, and more prominent astigmatism in cylindrical power less than -1.00 D subgroups.

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“…In 2005, Chew et al [26] mentioned three different mydriatic regimens for ROP screening in premature infants with dark irides: (1) cyclopentolate 1% + phenylephrine 2.5%, (2) tropicamide 1% + phenylephrine 2.5%, and (3) normal saline + phenylephrine 1% + cyclopentolate 0.2%. Although a composition prepared by cyclopentolate 0.2% + phenylephrine 1% eyedrops was considered the best mydriatic regimen in premature infants with dark irides, as these premature and small infants are especially prone to central nervous system and cardiopulmonary side effects from systemic absorption of cyclopentolate [28,29,30], we preferred to use tropicamide instead of cyclopentolate in all children despite of the possibility of gaining poorer cycloplegic effect to avoid the probable cyclopentolate side effects. This drawback is relevant for both groups and all examination periods.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers

Roohipoor

Karkhaneh²,

Esfahani³

et al. 2016

Ophthalmologica

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Aim: To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode and red lasers. Methods: A randomized double-masked clinical trial was performed, and infants with threshold or prethreshold type 1 ROP were assigned to red or diode laser groups. Gestational age, birth weight, pretreatment cycloplegic refraction, time of treatment, disease stage, zone and disease severity were recorded. Patients received either red or diode laser treatment and were regularly followed up for retina assessment and refraction. The information at month 12 of corrected age was considered for comparison. Results: One hundred and fifty eyes of 75 infants were enrolled in the study. Seventy-four eyes received diode and 76 red laser therapy. The mean gestational age and birth weight of the infants were 28.6 ± 3.2 weeks and 1,441 ± 491 g, respectively. The mean baseline refractive error was +2.3 ± 1.7 dpt. Posttreatment refraction showed a significant myopic shift (mean 2.6 ± 2.0 dpt) with significant difference between the two groups (p < 0.001). There was a greater myopic shift among children with zone I and diode laser treatment (mean 6.00 dpt) and a lesser shift among children with zone II and red laser treatment (mean 1.12 dpt). The linear regression model, using the generalized estimating equation method, showed that the type of laser used has a significant effect on myopic shift even after adjustment for other variables. Conclusion: Myopic shift in laser-treated ROP patients is related to the type of laser used and the involved zone. Red laser seems to cause less myopic shift than diode laser, and those with zone I involvement have a greater myopic shift than those with ROP in zone II.

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Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Cited by 10 publications

References 5 publications

Systemic Effects of Ophthalmic Cyclopentolate on Body Weight in Neonatal Mice

Systemic Effects of Ophthalmic Cyclopentolate on Body Weight in Neonatal Mice

Refractive Outcomes of Table-Mounted and HandheldAuto-Refractometers in Children: An Observational Cross-Sectional Study

Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers

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