Comparison of mydriatic regimens used in screening for retinopathy of prematurity in preterm infants with dark irides

Carmen Chew, Ropilah Abdul Rahman, Suraiya M. Shafie, Zainal Mohamad

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    Purpose: To determine the mydriatic regimen that provides optimal dilation of the pupil with minimal systemic side effects for screening of retinopathy of prematurity. Methods: This cross-sectional, randomized, double-masked clinical trial compared cyclopentolate 1% + phenylephrine 2.5%, tropicamide 1% + phenylephrine 2.5%, and a prepared combination of cyclopentolate 0.2% with phenylephrine 1% for pupillary dilation in preterm infants with dark irides. Thirteen infants were randomized to each regimen. Outcomes measured were pupillary dilation, heart rate, blood pressure, abdominal girth, and intolerance to feeds. Results: All three mydriatic regimens provided adequate pupillary dilation at 45 minutes, with dilation sustained at 60 minutes. There was a significant increase in mean blood pressure in the cyclopentolate 1% + phenylephrine 2.5% and the tropicamide 1% + phenylephrine 2.5% groups. Although there was no significant change of abdominal girth in any of the three groups, a total of eight patients developed intolerance to feeds; four (50%) of these infants were from the cyclopentolate 1% + phenylephrine 2.5% group. Conclusion: The prepared combination of cyclopentolate 0.2% + phenylephrine 1% appears to be the mydriatic of choice for preterm infants with dark irides as it provided adequate pupillary dilation with the least systemic side effects.

    Original languageEnglish
    Pages (from-to)166-173
    Number of pages8
    JournalJournal of Pediatric Ophthalmology and Strabismus
    Volume42
    Issue number3
    Publication statusPublished - May 2005

    Fingerprint

    Mydriatics
    Retinopathy of Prematurity
    Cyclopentolate
    Phenylephrine
    Iris
    Premature Infants
    Dilatation
    Tropicamide
    Blood Pressure
    Pupil
    Heart Rate
    Clinical Trials

    ASJC Scopus subject areas

    • Ophthalmology
    • Pediatrics, Perinatology, and Child Health

    Cite this

    Comparison of mydriatic regimens used in screening for retinopathy of prematurity in preterm infants with dark irides. / Chew, Carmen; Rahman, Ropilah Abdul; Shafie, Suraiya M.; Mohamad, Zainal.

    In: Journal of Pediatric Ophthalmology and Strabismus, Vol. 42, No. 3, 05.2005, p. 166-173.

    Research output: Contribution to journalArticle

    Chew, Carmen ; Rahman, Ropilah Abdul ; Shafie, Suraiya M. ; Mohamad, Zainal. / Comparison of mydriatic regimens used in screening for retinopathy of prematurity in preterm infants with dark irides. In: Journal of Pediatric Ophthalmology and Strabismus. 2005 ; Vol. 42, No. 3. pp. 166-173.
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    abstract = "Purpose: To determine the mydriatic regimen that provides optimal dilation of the pupil with minimal systemic side effects for screening of retinopathy of prematurity. Methods: This cross-sectional, randomized, double-masked clinical trial compared cyclopentolate 1{\%} + phenylephrine 2.5{\%}, tropicamide 1{\%} + phenylephrine 2.5{\%}, and a prepared combination of cyclopentolate 0.2{\%} with phenylephrine 1{\%} for pupillary dilation in preterm infants with dark irides. Thirteen infants were randomized to each regimen. Outcomes measured were pupillary dilation, heart rate, blood pressure, abdominal girth, and intolerance to feeds. Results: All three mydriatic regimens provided adequate pupillary dilation at 45 minutes, with dilation sustained at 60 minutes. There was a significant increase in mean blood pressure in the cyclopentolate 1{\%} + phenylephrine 2.5{\%} and the tropicamide 1{\%} + phenylephrine 2.5{\%} groups. Although there was no significant change of abdominal girth in any of the three groups, a total of eight patients developed intolerance to feeds; four (50{\%}) of these infants were from the cyclopentolate 1{\%} + phenylephrine 2.5{\%} group. Conclusion: The prepared combination of cyclopentolate 0.2{\%} + phenylephrine 1{\%} appears to be the mydriatic of choice for preterm infants with dark irides as it provided adequate pupillary dilation with the least systemic side effects.",
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