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Lina Krepste, Alon Harris, Ingrida Januleviciene, Vilma Balciuniene, Lina Siaudvytyte, Ruta Barsauskaite, Austin Gerber, Brent Siesky; The Effect of Diluted Sterile Penetration Enhancer Solution in Nebulized Mist and Liquid Drop Forms on Ocular Circulation in Patients with Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4663.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the retrobulbar blood flow (RBF) effects and subjective discomfort of diluted penetration enhancer solution (DPES) in nebulized mist as opposed to liquid drop in patients with diabetic retinopathy (DR).
A prospective, nonrandomized clinical trial collected data from 20 patients (40 eyes) with mild-to-moderate nonproliferative DR. Color Doppler imaging (CDI) was used to assess peak systolic (PSV) and end diastolic (EDV) velocities, and calculated resistance index (RI) in the ophthalmic (OA) and central retinal arteries (CRA). Sterile DPES was made in 4:1 proportions of sterile distilled water and saponin liquid (consisted of water, sodium laureth sulfate, cocamidopropyl betaine, glycerin, ammonium xylenesulfonate, disodium phosphate, citric acid). A saline nebulizer, DPES nebulizer or DPES drop was individually applied to one eye, and RBF was analyzed at baseline, 1 minute and 5 minutes post-treatment. Patients were asked about discomfort upon every application. Statistical data analysis was performed using the computer program SPSS 17.0 for Windows. Student’s t Test, Mann-Whitney U test and Paired Samples t test were used.
Saline mist application significantly increased OA velocities at 5 minutes (PSV from 40.3±6.5 to 43.1±7.6 cm/s, EDV from 6.7±2.7 from 7.9±3.2 cm/s). The DPES mist significantly increased OA velocities at 5 minutes (PSV from 35.3±8.5 to 38.8±9.2 cm/s, EDV from 6.4±3.7 to 7.4±3.2 cm/s in the left eye during the first stage of the study; PSV from 40.7±6.8 to 44.4±5.9 cm/s, EDV from 7.0±2.6 cm/s to 9.2±2.5 cm in the right eye during the second stage), and increased CRA PSV at 1 minute (from 10.6±1.8 to 11.4±1.8 cm/s in the left eye during the first stage; from 10.6±2.3 to 12.0±3.1 cm/s in the right eye during the second stage) and at 5 minutes (to 12.0±2.1 cm/s and to 11.5±2.1 cm/s, respectively). DPES drop application increased OA PSV from 36.6±9.6 to 39.8±10.9 cm/s at 1 minute and to 40.5±10.1 cm/s at 5 minutes and CRA PSV from 10.6±2.3 to 11.2±2.3 cm/s at 1 minute and to 11.7±2.0 cm/s at 5 minutes. Irritation was noted by 20 patients after DPES drip and by none after application of mists.
Application of a DPES mist in patients with DR does not cause ocular irritation as compared to liquid drop application while showing similar increase in RBF and decrease in RI.
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