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K. Sugiyama, F. Okamoto, J. Sonoo, K. Takahashi, T. Hiraoka, T. Oshika; The Influence of Alpha(1)-Adrenoceptor Antagonists on Pupillary Function. Invest. Ophthalmol. Vis. Sci. 2008;49(13):393. doi: https://doi.org/.
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Intraoperative floppy iris syndrome (IFIS) is a small-pupil syndrome in patients who are receiving systemic alpha(1)-adrenoceptor antagonist to treat benign prostatic hypertrophy. We investigated the influence of systemic alpha(1)-adrenoceptor antagonists on pupillary function using videopupillography.
Fifty-nine eyes of 33 patients who are receiving systemic tamsulosin (alpha(1A) selective antagonist), 50 eyes of 28 patients with naftopidil (alpha(1A) and (1D) antagonist), and 98 eyes of 53 age-matched normal controls were included into the study. Exclusion criteria included patients with previous history of ocular surgery, ocular and systemic disorders affecting pupil function such as pseudoexfoliation, glaucoma, and diabetes mellitus. Pupil diameter and dynamics were measured using videopupillography (IRISCORDER C7364). Pupil diameter was measured in photopic, dark and pharmacologically-dilated conditions. This device projects a light stimulus of 1 second and calculates several parameters, such as maximum contraction velocity (VCmax), maximum dilation velocity (VDmax), and contraction rate (CR). From the data obtained by videopupillography, modified-VCmax and modified-VDmax was calculated.
The dark and dilated pupil diameters, modified-VCmax and modified-VDmax were significantly reduced in the tamsulosin group than in the normal controls. The photopic, dark, and dilated pupil diameters were significantly lower in the naftopidil group than in the normal controls, but there was no significant difference in pupil dynamics between these groups.
Systemic alpha(1)-adrenoceptor antagonists affect pupillary function. Tamsulosin has significant influence on not only pupil diameter but also pupil dynamics.
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