Schimidbauer J M, Höh H, Franke G, Petsch E, Siegmund W
Augenklinik, Klinikum Neubrandenburg.
Ophthalmologe. 1999 Mar;96(3):182-6. doi: 10.1007/s003470050392.
Dapiprazole hydrochloride is an alpha-1-adrenergic inhibitor that anticipates the mydriatic effect of phenylephrine in dilator muscle receptors in a competitive way. The aim of this study was to determine for which indications for mydriasis pupil dilation by phenylephrine alone is sufficient and if the reversal by dapiprazole is convenient and the practical.
In 286 eyes of 147 outpatients, the pupil was dilated for fluorescein angiography-FLA (100 eyes of 50 patients), examination of the fundus-Fd (99 eyes of 52 patients), central argon laser coagulation-cALC) (64 eyes of 32 patients), peripheral argon laser coagulation-pALC (16 eyes of 9 patients) and Nd:YAG capsulotomy (7 eyes of 4 patients) with phenylephrine 10% eyes drops, followed by reversal by dapiprazole 0.5%. The width and mobility of the pupil were tested at intervals of 10 min. When mydriasis by phenylephrine was insufficient, tropicamide was applied additionally.
In 98% of FLA with scanning laser ophthalmoscope, 75% of cALC, 76% of Fd, 62% FLA with fundus camera and 38% of pALC, mydriasis could be reached that was sufficient for the indication. Diabetics showed significantly more sluggish pupil mobility (t1/2: P < 0.05 mydriasis, P < 0.005 reversal). The mean duration after using dapiprazole until reaching the starting value (+/- 1 mm) of the pupil was 44.3 +/- 26.3 min. In 86% of the examined eyes, the pupil reached its starting value within 1 h. The subjective degree of satisfaction with the application of dapiprazole was "satisfied" to "very satisfied" (5.4 +/- 1.4 points on a scale from 1 to 7 points).
In fundus examination, fluorescein angiography by a laser scanner, diagnostic retinal examination and central laser coagulation, the combination phenylephrine/dapiprazole was most suitable. In our opinion, the combination is less suitable for peripheral argon laser coagulation and fluorescein angiography using a fundus camera.
盐酸达哌唑是一种α-1肾上腺素能抑制剂，它以竞争性方式在散瞳肌受体中对抗去氧肾上腺素的散瞳作用。本研究的目的是确定单独使用去氧肾上腺素散瞳适用于哪些散瞳指征，以及达哌唑的散瞳逆转是否方便且实用。
在147名门诊患者的286只眼中，使用10%去氧肾上腺素滴眼液散瞳以进行荧光素血管造影（FLA）（50例患者的100只眼）、眼底检查（Fd）（52例患者的99只眼）、氩激光中央凝固术（cALC）（32例患者的64只眼）、氩激光周边凝固术（pALC）（9例患者的16只眼）和Nd:YAG晶状体囊切开术（4例患者的7只眼），随后使用0.5%达哌唑进行散瞳逆转。每隔10分钟测试瞳孔的宽度和活动度。当去氧肾上腺素散瞳不足时，额外使用托吡卡胺。
在使用扫描激光检眼镜进行的98%的FLA、75%的cALC、76%的Fd、使用眼底照相机进行的62%的FLA和38%的pALC中，可以达到足以满足指征的散瞳效果。糖尿病患者的瞳孔活动明显更迟缓（散瞳时t1/2：P<0.05，散瞳逆转时P<0.005）。使用达哌唑后直至瞳孔达到起始值（±1mm）的平均持续时间为44.3±26.3分钟。在86%的受检眼中，瞳孔在1小时内达到其起始值。对达哌唑应用的主观满意度为“满意”至“非常满意”（在1至7分的量表上为5.4±1.4分）。
在眼底检查、激光扫描仪荧光素血管造影、诊断性视网膜检查和氩激光中央凝固术中，去氧肾上腺素/达哌唑组合最为合适。我们认为，该组合不太适用于氩激光周边凝固术和使用眼底照相机的荧光素血管造影。
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