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At least 19 recordsLinked to original sources
PubMed1976

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. IV. Fluorescein angiography of the vessels of the iris in open-angle glaucoma eyes with a positive cyclopentolate response.

Fluorescein angiography of the iris (IFAG) was performed on 15 patients with a positive cyclopentolate response (IOP elevation greater than or equal to 8 mmHg) in 17 eyes to the cyclopentolate provocative test. The chamber angles were open in all the eyes. Seven of the responder eyes had capsular glaucoma undergoing treatment, six had simple glaucoma, two had pigmentary glaucoma and two suspicion of open-angle glaucoma. The object was to study with IFAG whether vascular changes can be established in the iris of the responder eyes such as could have a role in the elevation of IOP. All the eyes with capsular glaucoma displayed vascular changes, vasoproliferation and fluorescein leakage from the iris vessles. No other vascular changes were seen in the irises of the responder eyes. IFAG revealed no differences in the iris vasculature between responder and non-responder eyes. A vascular aetiology for the IOP elevation in responders is improbable.

Cyclopentolate↗
PubMed1988

Comparison of 0.5% cyclopentolate plus 0.5% tropicamide and 1% cyclopentolate alone for mydriasis of dark irides.

We studied the mydriatic and cycloplegic effect of a single dose of a combination of 0.5% cyclopentolate hydrochloride and 0.5% tropicamide in 20 healthy subjects with dark brown irides. The mean change in dilatation with the combination drop was 3.5 mm, compared with 0.6 mm with 1% cyclopentolate alone (p less than 0.001). In 92% of 26 eyes studied the difference in refraction between the combination drop and 1% atropine was +1.00 dioptre or less. The combination drop safely provided satisfactory mydriasis and cycloplegia in 20 minutes, allowing for rapid and accurate examination of these patients.

Atropine↗
PubMed1976

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. III. The significane of pigment for the result of the cyclopentolate provocative test in suspected or untreated open-angle glaucoma.

Significant elevations of IOP, i. e. responses, occurred in eyes with suspected or untreated open-angle glaucoma during the mydriasis test with 1% cyclopentolate (CPT). The possible role of pigment in the IOP elevations seen in the responders was studied. Pigment was liberated in the aqueous, sometimes very profusely, in 88 (31.9%) of 276 eyes during CPT. The maximal IOP elevations, ad 20 mmHg, were seen in just these eyes. They were eyes with capsular or pigmentary glaucoma or eyes in which exceptionally heavy pigment was demonstrated in the chamber angle for other reasons. There was a statistically significant correlation between pigment liberation and IOP elevation during CPT. Evidently profuse pigment liberation may have caused transient blocking of the trabecular meshwork, obstruction of aqueous outflow and elevation of IOP. Liberation of pigment in the aqueous during CPT was statistically highly significantly more profuse in eyes with pseudoexfoliation than in eyes without pseudoexfoliation. An equally significant correlation with demonstrated between the grade of chamber angle pigmentation and the degree of pigment liberation during CPT. The significance of pigment for IOP elevation was seen also in the statistically highly significantly more profuse pigmentation of the chamber angle in the responder than in the non-responder eyes.

Aqueous Humor↗
PubMedDate not supplied

The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma.

PURPOSE: To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. METHODS: Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. RESULTS: Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p = 0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p = 0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p < 0.05) and RI of the posterior ciliary artery increased significantly (p = 0.01) after cyclopentolate instillation. CONCLUSIONS: On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells.

Aged↗
PubMed1998

The cycloplegic effects of cyclopentolate and tropicamide on myopic children.

Thirty-seven myopic children were given either 1-2 drops of 1% cyclopentolate or 1% tropicamide twice with 5 min intervals to evaluate the time course and maximal cycloplegic effect of both agents. The other fifteen subjects were given 1% tropicamide initially, then 1% cyclopentolate given after 30 min of maximal effect of tropicamide appeared to evaluate whether the effect of cyclopentolate was superior to tropicamide. Cycloplegic refraction was measured with an auto-refractometer (Topcon RK-3000) before drug delivery and every 15 min thereafter, for 90 min. The maximal cycloplegic effect of cyclopentolate was around 45 min, then it remained stable until 90 min after the last instillation. The effect of tropicamide was faster than that of cyclopentolate. It was around 30 min, then it stabilized until 75 min. The extra effect of cyclopentolate over tropicamide was minimal (only -0.1D). The power of cornea and astigmatism were not affected by either agent. However, a big variation in astigmatism was noted during the course, especially with cyclopentolate. This study suggests that 1% tropicamide should be a good agent for routine refractive status checking on myopic children.

Accommodation, Ocular↗
PubMed1987

The effects of thymoxamine, phenylephrine and cyclopentolate on the accommodative process in man.

Accommodation of the eye was measured in a cross-over study in 11 healthy volunteers (20-35 years). In 5 subjects the near point was determined before and after topical instillation of 5 microliter of 0.1% and 0.5%, and 5 x 5 microliter 0.5% thymoxamine, 5 microliter of 2% and 10%, and 5 x 5 microliter 10% phenylephrine and 5 microliter of 0.04%, 0.2%, and 1% cyclopentolate. All concentrations of thymoxamine increased the accommodative amplitude by about 1.5 dioptres. Accommodation decreased by about 0.5 dioptre after instillation of 5 x 5 microliter 10% phenylephrine. The cycloplegic effects of 0.2% and 1% cyclopentolate were similar. Accommodation was also determined after application of 5 microliter 1% cyclopentolate followed by either 5 x 5 microliter 0.5% thymoxamine or 10% phenylephrine. Addition of thymoxamine did not alter the cycloplegic response of cyclopentolate alone. Addition of phenylephrine caused a more prolonged but similar maximum response compared to that of cyclopentolate alone. In the 6 other test subjects, the accommodation was compared before and after topical instillation of 5 microliter of 0.2% and 1% and 40 microliter (one standard eye-drop) of 1% cyclopentolate and followed during 6 h. There was no difference between the maximum value of 5 microliter and 40 microliter 1% cyclopentolate. We conclude from these data that alpha-stimulation by phenylephrine decreases and alpha-inhibition by thymoxamine increases the accommodative amplitude in man.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular↗
PubMed2005

Comparison of tropicamide and cyclopentolate for cycloplegic refractions in myopic adult refractive surgery patients.

PURPOSE: To compare tropicamide 1%, a shorter-acting cycloplegic agent, with cyclopentolate 1% for cycloplegic refractions in adult refractive surgery patients. SETTING: Navy Refractive Surgery Center, Ophthalmology, Naval Medical Center, San Diego, California. METHODS: The study was prospective, single center, with randomized sequencing of cycloplegic agent; each patient received both agents. Thirty consecutive myopic adult refractive surgery patients (mean age 35.4 years) participated. A complete preoperative examination, including cycloplegic refraction, was obtained twice, 1 week apart. The patient and the examiner were masked to the medication. Main outcome measures included cycloplegic and manifest refractions, best corrected distance acuity, near-point accommodation, pupil diameters, and subjective appraisal of experience with cycloplegic agents. RESULTS: Twenty-eight of 30 patients completed both examinations. Both eyes were measured, but comparisons were limited to right and left eyes, independently. No statistically significant difference was found between the tropicamide and cyclopentolate cycloplegic refractions (mean difference in MSE +/- SD, OD=0.054 +/- 0.214 diopters (D), t=1.33, P=.10; OS=0.054 +/- 0.253 D, t=1.12, P=.14). Five eyes of 3 patients had a difference of 0.50 D or greater between the 2 agents; less myopia with cyclopentolate. Near-point testing revealed less residual accommodation with cyclopentolate (difference in MSE, OD=-0.27 +/- 0.51 D, t=2.68, P=.006; OS=-0.32 +/- 0.49 D, t=3.46, P=.001). Subjectively, 24 of 28 (86%) patients preferred tropicamide, 1 (4%) preferred cyclopentolate, and 3 (10%) had no preference. CONCLUSIONS: There was no statistically significant difference in mean cycloplegic refractions. Cyclopentolate was more effective than tropicamide in reducing accommodative amplitude in adult myopes (near-point testing). Patients strongly preferred tropicamide.

Accommodation, Ocular↗
PubMed1985

Effects of cyclopentolate eyedrops on gastric secretory function in pre-term infants.

Because of a report of necrotizing enterocolitis and death of a neonate from cyclopentolate eyedrops, we prospectively studied the effects of cyclopentolate 0.5% and 0.25% ophthalmic solutions and of a placebo on gastric volume and acid secretions in 20 pre-term infants. Placebo and cyclopentolate 0.25% eyedrops had no significant effect on the tested gastric functions. However, cyclopentolate 0.5% eyedrops significantly decreased gastric acid secretion and volume. Since this effect may predispose to the development of gastroenteritis, we recommend that cyclopentolate 0.5% be avoided in preterm infants; a weaker concentration of cyclopentolate eyedrops, however, can be used for mydriasis.

Achlorhydria↗
PubMed1992

The effect of some macromolecular ionic complexes on the pharmacokinetics and -dynamics of ocular cyclopentolate in rabbits.

The effect of mucoadhesive polymeric vehicles on the mydriatic efficacy, and on the systemic and ocular absorption of cyclopentolate from eyedrops was studied in albino rabbits. Combining cyclopentolate base to polygalacturonic (CY-PGA) or hyaluronic (CY-HA) acid resulted in an increased mydriatic effect when compared with cyclopentolate hydrochloride (CY-HCl). During the first half an hour, the systemic absorption of cyclopentolate was lower after CY-PGA than after CY-HCl. The ocular penetration of cyclopentolate, based on drug concentrations in aqueous humor 30 minutes after the eyedrop instillation, was increased 3 fold when the polygalacturonate complex was used. CY-PGA, as well as other polymeric salts, might offer a possibility to increase the therapeutic index of cyclopentolate.

Absorption↗
PubMed1993

Comparison of cyclopentolate versus tropicamide cycloplegia in children.

This double masked study compares the cycloplegic effects of tropicamide 1% and cyclopentolate 1% in 20 nonstrabismic, nonamblyopic, hyperopic 6- to 12-year-old children with a mean refractive error = +1.48 +/- 1.10 diopters (D). Unlike previous studies which used only amplitude of accommodation to measure the depth of cycloplegia, this study compares refractive error as determined by retinoscopy, distance subjective refraction, and distance autorefraction (Canon R-1). In addition, we compare the amplitude of accommodation as measured by subjective push-up and objective autorefraction methods. There is no statistically significant difference between cyclopentolate and tropicamide for either cycloplegic retinoscopy or distance subjective refraction. Autorefraction measurement of refractive error shows a statistically significant but clinically unimportant bias (0.14 +/- 0.30 D) toward more hyperopia with cyclopentolate. Both drops reveal latent hyperopia, and the mean latencies are not statistically different between the two cycloplegic agents. Latent hyperopia is not systematically related to the degree of hyperopia after tropicamide, but this relation is significant after cyclopentolate. No differences were found between refractive results with either agent at 30 min compared to 60 min after drop instillation. When measured objectively with the autorefractor, accommodation is inhibited more effectively by cyclopentolate than by tropicamide. Our results suggest that although tropicamide is not as effective as cyclopentolate in inhibiting accommodation it is, nevertheless, a useful cycloplegic agent for measuring distance refractive error of low to moderate hyperopia in school-aged children.

Accommodation, Ocular↗
PubMed1988

Status of cyclopentolate as a cycloplegic in children: a comparison with atropine and homatropine.

We compared the cycloplegic effects of cyclopentolate, homatropine and atropine by the retinoscopy findings and residual accommodation left following their use in the same individual. The mean residual accommodation measured after the use of cyclopentolate, homatropine and atropine was 1.48 +/- 0.33 D, 2.32 +/- 0.37 D and 1.10 D +/- 0.28 D, respectively, and the mean difference in retinoscopy readings between cyclopentolate and homatropine, homatropine and atropine, and atropine and cyclopentolate was 0.46 +/- 0.21, 0.71 +/- 0.23 and 0.26 +/- 0.14, respectively. We further observed that a tonus allowance of about +0.75 D would suffice for cyclopentolate. The merits for recommending cyclopentolate as a routine cycloplegic in children are discussed.

Accommodation, Ocular↗
PubMed1991

[The effects on accommodative and pupillary responses by topical application of cyclopentolate hydrochloride].

Accommodative and pupillary responses, refractive change, and visual acuity after 30 microliters instillation of cyclopentolate hydrochloride of various concentrations (0.00625-0.1%) in 6 young normal males (27.0 +/- 0.6 yrs) were investigated. Both accommodative and pupillary responses were measured by an infrared optometer, at pre-instillation and 1, 3, 6, 9 and 24 hours post-instillation. No significant effects were induced by concentrations of cyclopentolate hydrochloride 0.0125% or less. Reduced amplitude of accommodation and enlarged pupil were, however, observed by 0.025% and 0.05% of cyclopentolate hydrochloride from 1 through 9 hours post-instillation. Miotic response in accommodation was also reduced from 1-6 hours at the same concentrations. A concentration of 0.1% cyclopentolate hydrochloride showed both reduction of accommodation amplitude and enlarged pupil for 24 hours after instillation. However, neither refraction nor visual acuity was affected by any concentration of cyclopentolate hydrochloride. The results suggest that cyclopentolate hydrochloride at concentrations up to 0.05% applied before sleep would not be accompanied by inhibitory effects on accommodation during the day.

Accommodation, Ocular↗
PubMed2001

Retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%.

PURPOSE: This study compares retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%. The study sample included 29 healthy, nonstrabismic infants 4 to 7 months of age (mean 5.71 months). METHODS: Each study subject was examined at two separate visits an average of 2 weeks apart (mean [+/-SD] 14 +/- 9 days). The examiner completed a case history, iris color grading, confrontation tests, and noncycloplegic near retinoscopy in a dark room and then instilled a drop of topical anesthetic in each eye followed by 2 drops of cycloplegic agent separated by 5 min. Retinoscopy was performed 25 to 30 min after the first drops were instilled. The bottles were masked, and the drop administered at the first visit was randomly assigned. RESULTS: On a scale of 0 to 4.9, the median iris grade was 4.0, which corresponds to a brown or darkly pigmented iris. All reported retinoscopy results are for the horizontal meridian of the right eye. The mean refractive error using noncycloplegic near retinoscopy was +0.94 D (+/-1.19 D). The mean refractive error was +1.81 D (+/-1.19 D) with tropicamide and +1.88 D (+/-1.45 D) with cyclopentolate. There was no statistically or clinically significant difference between the two cycloplegic measurements using different diagnostic agents (t = -0.46, p = 0.65). The mean difference between noncycloplegic and cycloplegic retinoscopy was 0.89 D (+/-0.66 D) with tropicamide (t = -6.57, p < 0.0001) and 1.04 D (+/-0.94 D) with cyclopentolate (t = -5.38, p < 0.0001; all two-sided paired t-tests). There were no serious adverse reactions with either agent, although one infant temporarily developed redder than normal cheeks after instillation of cyclopentolate. CONCLUSION: Our results suggest that tropicamide is as effective as cyclopentolate for the measurement of refractive error in most healthy, nonstrabismic infants.

Ciliary Body↗
PubMed1998

Systemic and ocular absorption and antagonist activity of topically applied cyclopentolate in man.

Ocular and systemic absorption and antagonist activity of topical 1% cyclopentolate were studied in 11 elderly patients undergoing extracapsular cataract extraction, and in 8 healthy female volunteers. The patients received two 35 microl drops of cyclopentolate unilaterally and the healthy volunteers one 30 microl drop bilaterally to the lower conjunctival cul-de-sac of the eye. The drug concentrations were measured with radioreceptor assay and receptor occupancies with radiooccupancy assay using isolated rat brain muscarinic cholinoceptors. In the patient group, cyclopentolate concentrations in aqueous humour were approximately 3000 times higher than those in plasma. Muscarinic cholinoceptors were occupied totally (more than 99.9%) by aqueous humour and 3-18% by plasma taken at 55-125 min. after the drug application. In healthy volunteers peak plasma concentration of cyclopentolate, 2.06+/-0.86 (mean+/-S.D.) nM, occurred at 53 min., maximum receptor occupancy being 5.9+/-2.1%. The maximum pupillary dilatation occured at 30 min. after the drug application. At the same time the near point of vision was extended to more than 50 cm in all subjects. After topical application plasma receptor occupancy was not high enough to cause any significant changes in heart rate and in PQ time. None of the subjects experienced subjectively or objectively adverse effects to be attributed to cyclopentolate.

Absorption↗
PubMed2006

The effect of phenylephrine and cyclopentolate on objective wavefront measurements.

PURPOSE: To investigate the impact of phenylephrine and cyclopentolate on wavefront refraction and fourth order spherical aberration C12. METHODS: This cohort study comprised 151 eyes with sphere up to -10.00 diopters (D) and cylinder -3.75 D. Aberrometry was performed using the ALLEGRO WAVE (WaveLight Laser Technologies AG, Erlangen, Germany) after instillation of phenylephrine 5% yielding objective phenylephrine refraction in accommodated steady-state, as well as after cyclopentolate 0.5% providing objective cyclopentolate refraction in non-accommodated state. Accommodation target fogging was turned off. Wavefront aberrations were expressed by Zernike expansion up to the sixth order, and paraxial curvature matching with Taylor series was used to calculate objective wavefront sphere. RESULTS: Objective wavefront sphere was not influenced by pupil size. Eyes showed substantial accommodation after phenylephrine with a myopic shift of -0.66 D comparing objective to subjective manifest sphere (r=0.942, P<.001). Cycloplegic eyes behaved like a model eye, with a difference of -0.08 D between objective and subjective cycloplegic sphere (r=0.976, P<.001). C12 increased ten-fold from 4.0- to 7.0-mm pupil size, keeping the same sign. Comparing cyclopentolate with phenylephrine, the sign of C12 changed in a positive direction by an average +0.124 +/- 0.109 microm (range: -0.052 to +0.632 microm) at 7.0 mm, whereas the total higher order aberrations changed very little. A good correlation was found between C12 and the change in objective wavefront sphere between cyclopentolate and phenylephrine (r=0.75, P<.001). CONCLUSIONS: Fogging of the accommodation target should be used for wavefront measurements. Weaker cycloplegic agents, such as tropicamide, may be used to ensure relaxed but not completely paralyzed accommodation, which would yield "manifest" aberration values close to the natural resting state.

Accommodation, Ocular↗
PubMed1992

Systemic absorption of ocular cyclopentolate in children.

Cyclopentolate plasma levels were quantitated and heart rate and pupil size were monitored after ocular application of the drug to juveniles. In all, 12 children were given one 35-microliters eyedrop of either 1% cyclopentolate (n = 6) or placebo (n = 6) in randomized order in the lower cul-de-sac of one eye. A sensitive radioreceptor assay was used to determine the systemic drug absorption. With the exception of one child, detectable cyclopentolate concentrations were seen in plasma at as early as 3 min after the ocular drug application. There was a marked interindividual variation in peak plasma cyclopentolate concentrations ranging from undetectably low to 5.8 ng/ml (median, 2.9 ng/ml). In some children a second drug concentration peak was detected. Cyclopentolate increased the pupillary diameter from 4.8 +/- 1 mm before drug application to 8 +/- 0.9 mm at 30 min after administration, but the children's heart rate did not alter.

Absorption↗
PubMed1990

Reduced mydriasis from repeated doses of tropicamide and cyclopentolate.

Pupils are often dilated for examination the day before surgery and again on the day of surgery. The following experiment was performed to determine the effect of serial doses of two commonly used mydriatic agents: on two consecutive days the pupil of one of the eyes of 28 subjects was dilated with tropicamide 1%, and the pupil of one of the eyes of 30 subjects was dilated with cyclopentolate hydrochloride 1%. The other eyes in both groups were dilated only on the second day, and thus served as controls. Pupil sizes were measured from photographs before and after dilation. The pupils of the eyes treated twice with either drug did not dilate as well after the second dose as those of the control eyes (P less than .005 for tropicamide, P less than .001 for cyclopentolate). The pupils of the eyes twice-treated with tropicamide were an average of 0.15 mm smaller than the control pupils; those twice-treated with cyclopentolate were 0.36 mm smaller. For subjects treated with cyclopentolate, this decreased mydriasis was related to age (P less than .05) and to eye color (P less than .025): the younger and blue-eyed subjects dilated less on the second day than the older and brown-eyed subjects. If full mydriasis is required at surgery, pupils should probably not be dilated with either tropicamide or cyclopentolate the day before surgery.

Adult↗