2019
DOI: 10.1136/bmjpo-2019-000448
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Systematic review of mydriatics used for screening of retinopathy in premature infants

Abstract: IntroductionRoutine retinopathy of prematurity eye examinations are an important part of neonatal care, and mydriatic medicines are essential in dilating the pupil for the eye examination. There are concerns about the level of evidence for efficacy and safety of these mydriatic medicines.ObjectiveThis review evaluates both efficacy and safety evidence of mydriatics used during the retinopathy of prematurity eye examination.MethodSystematic literature review.ResultsThere is limited evidence guiding clinical pra… Show more

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Cited by 27 publications
(23 citation statements)
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“…Some complications from mydriatic eyedrops have been reported in preterm infants. Systemic absorption of mydriatic eyedrops has been associated with cardiovascular, respiration and gastrointestinal adverse effects [ 2 , 3 ]. ROP screening using cyclopentolate may be associated with increased gastric residuals and delayed gastric emptying [ 4 , 5 ].…”
Section: Introductionmentioning
confidence: 99%
“…Some complications from mydriatic eyedrops have been reported in preterm infants. Systemic absorption of mydriatic eyedrops has been associated with cardiovascular, respiration and gastrointestinal adverse effects [ 2 , 3 ]. ROP screening using cyclopentolate may be associated with increased gastric residuals and delayed gastric emptying [ 4 , 5 ].…”
Section: Introductionmentioning
confidence: 99%
“…We note that the concentration of mydriatics used in this premature infant is at the mid-range of the commonly used doses. 2 Our research indicates that low-dose microdrop administration of phenylephrine and cyclopentolate may provide similar efficacy for pupil dilation; however, due to the small sample size, there is a need for further research in this field. 3 We agree with Mimori et al that, following systemic absorption, there is a plausible pharmacological mechanism for phenylephrine and tropicamide to increase the risk of NEC.…”
mentioning
confidence: 77%
“…The authors noted significant changes in heart rate, blood pressure, increased prevalence of necrotising enterocolitis and apnea. 11 A local study done by Mesina-Bayana and Arroyo (2005) stated that commercially available topical cycloplegic–mydriatic agents did not have any significant side effects among adult Filipino patients 12 ; however, these preparations are of higher concentration than needed for ROP screening purposes and current packaging is for adult dosing not neonatal dosing. 11 The actual conduct of the screening may in some instances cause unstable vital signs in a fragile neonate, with some authors highlighting reduction in heart rate due to the oculo-cardiac reflex in approximately 10% of infants following ROP screening.…”
Section: Introductionmentioning
confidence: 99%
“… 11 A local study done by Mesina-Bayana and Arroyo (2005) stated that commercially available topical cycloplegic–mydriatic agents did not have any significant side effects among adult Filipino patients 12 ; however, these preparations are of higher concentration than needed for ROP screening purposes and current packaging is for adult dosing not neonatal dosing. 11 The actual conduct of the screening may in some instances cause unstable vital signs in a fragile neonate, with some authors highlighting reduction in heart rate due to the oculo-cardiac reflex in approximately 10% of infants following ROP screening. 11 Unwarranted ROP examinations also burden the health system, not only its physicians, but also its government-subsidised insurance system—the Philippine Health Insurance Corporation.…”
Section: Introductionmentioning
confidence: 99%
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