Division of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Türkiye.
Department of Neonatology, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Am J Perinatol. 2024 May;41(S 01):e324-e330. doi: 10.1055/a-1877-7868. Epub 2022 Jun 17.
Mydriatic eye drops used for retinopathy of prematurity (ROP) examination can cause systemic effects, and there are case reports of serious adverse effects in the literature. In this prospective study, we aimed to evaluate the early hemodynamic effects of mydriatic eye drops to understand the possible mechanisms of adverse effects.
Between December 2018 and March 2019, preterm babies less than 32 gestational weeks and who underwent ophthalmologic examination in our unit were included. The vital signs (heart rate, respiratory rate, oxygen saturation [SpO], and blood pressure values), cerebral and mesenteric tissue saturation by near-infrared spectroscopy (NIRS), and left ventricular functions of infants were recorded before and after applying mydriatic eye drops (2.5% phenylephrine and 0.5% tropicamide). The data were compared statistically. Strict adherence to prevent systemic absorption of the eye drops was applied.
Thirty-two mydriasis procedures were evaluated in 26 patients. The mean gestational age was 28.5 ± 1.7 weeks, and the mean birth weight was 943 ± 233 g. There were no significant differences in terms of vital signs of infants including heart rate, blood pressure, and oxygen saturation [SpO] levels before and after eye-drop application. In addition, NIRS values showed no significant differences between before and after measurements. No significant differences were detected at echocardiographic evaluation performed before and after mydriatic administration. No adverse reaction was observed in the study population during the study.
This is the first study that evaluated the early hemodynamic effects of mydriatic eye drops used for ROP screening by vital signs, NIRS, and echocardiographic evaluation. Mydriatic eye drops have no significant effect on early hemodynamic parameters including vital signs, NIRS, and echocardiographic findings in preterm infants. We suggest that a cautious approach for avoiding the systemic absorption of these agents may prevent the possible early systemic effects in this high-risk population.
· Mydriatic eye drops are commonly used for pupil dilatation before retinopathy of prematurity examination, and there are reports of serious adverse events caused by these drops.. · Due to the adverse events of eye drops, hemodynamic effects of these agents were investigated by clinical findings, near-infrared spectroscopy, and echocardiography.. · No significant early hemodynamic effect was observed so avoiding systemic effects may be prevented with precautions..
用于早产儿视网膜病变（ROP）检查的散瞳眼药水可引起全身作用，文献中有严重不良反应的病例报告。在这项前瞻性研究中，我们旨在评估散瞳眼药水的早期血液动力学效应，以了解不良反应的可能机制。
2018 年 12 月至 2019 年 3 月，在我们科室接受眼科检查的不足 32 孕周的早产儿被纳入研究。在使用散瞳眼药水（2.5%苯肾上腺素和 0.5%托品酰胺）前后，记录婴儿的生命体征（心率、呼吸频率、血氧饱和度[SpO]和血压值）、近红外光谱（NIRS）脑和肠系膜组织饱和度和左心室功能。对数据进行统计学比较。严格遵守以防止眼药水的全身吸收。
在 26 例患者中评估了 32 次散瞳术。平均胎龄为 28.5±1.7 周，平均出生体重为 943±233g。在眼药水使用前后，婴儿的生命体征（心率、血压和血氧饱和度[SpO]水平）均无显著差异。此外，NIRS 值在测量前后也无显著差异。在散瞳前和散瞳后进行的超声心动图评估中，未发现明显差异。在研究期间，研究人群中未观察到不良反应。
这是第一项通过生命体征、NIRS 和超声心动图评估来评估 ROP 筛查用散瞳眼药水早期血液动力学效应的研究。散瞳眼药水对早产儿的早期血液动力学参数（包括生命体征、NIRS 和超声心动图发现）没有显著影响。我们建议，谨慎避免这些药物的全身吸收可能会预防高危人群中可能的早期全身效应。
· 散瞳眼药水常用于早产儿视网膜病变检查前瞳孔扩张，有这些眼药水引起严重不良事件的报道。· 由于眼药水的不良反应，通过临床检查、近红外光谱和超声心动图研究了这些药物的血液动力学效应。· 未观察到明显的早期血液动力学效应，因此通过预防措施可能会预防全身效应。
