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Am J Perinatol 2024; 41(S 01): e324-e330
DOI: 10.1055/a-1877-7868
Original Article

Early Hemodynamic Effects of Mydriatic Eye Drops in Preterm Infants

Emre Dincer 
1   Division of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Türkiye
,
Ilker Gonen
2   Department of Neonatology, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
,
Helen A. Bornaun 
3   Department of Pediatric Cardiology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Türkiye
,
Beril Yasa
4   Department of Neonatology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Türkiye
,
Aslan Babayigit
5   Department of Neonatology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Türkiye
,
Ozge Kurum
6   Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Türkiye
,
Sadık E. Bayramoğlu
7   Department of Ophtalmology, University of Health Sciences, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Türkiye, Istanbul, Türkiye
,
Merih Cetinkaya
2   Department of Neonatology, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
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Abstract

Objective 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.

Study Design 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 [SpO2], 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.

Results 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 [SpO2] 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.

Conclusion 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.

Key Points

  • 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.

Keywords

retinopathy of prematurity - mydriasis - hemodynamics - newborn


Publication History

Received: 18 April 2022

Accepted: 23 May 2022

Accepted Manuscript online:
17 June 2022

Article published online:
02 September 2022

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