May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Effect of Cyclopentolate versus Atropine on Cycloplegic Refraction: The Multi-Ethnic Pediatric Eye Disease Study
Author Affiliations & Notes
  • R. N. Sanchez
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • F. Choudhury
    Preventative Medicine and Biostatistics, USC/Keck School of Medicine, Los Angeles, California
  • K. Tarczy-Hornoch
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • M. Borchert
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • S. A. Cotter
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • S. Azen
    Preventative Medicine and Biostatistics, USC/Keck School of Medicine, Los Angeles, California
  • R. Varma
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • The Multi-Ethnic Pediatric Eye Disease Study Group
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  R.N. Sanchez, None; F. Choudhury, None; K. Tarczy-Hornoch, None; M. Borchert, None; S.A. Cotter, None; S. Azen, None; R. Varma, None.
  • Footnotes
    Support  NIH Grants EY-14472, EY-03040, and Unrestricted Grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1454. doi:https://doi.org/
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      R. N. Sanchez, F. Choudhury, K. Tarczy-Hornoch, M. Borchert, S. A. Cotter, S. Azen, R. Varma, The Multi-Ethnic Pediatric Eye Disease Study Group; Effect of Cyclopentolate versus Atropine on Cycloplegic Refraction: The Multi-Ethnic Pediatric Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1454. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To compare the refractive error of hyperopic children aged 6 to 72 months as determined with cyclopentolate or atropine eye drops.

Methods: : 24 children aged 6-30 months (n=8) and 48-72 months (n=16) with spherical equivalent (SE) hyperopia >= 2.00 diopters (D) in either eye were examined. On Day 1, two drops of 1% cyclopentolate 5 minutes apart were instilled into both eyes (0.5% for children <= 12 months of age) and refractive error was measured 30 minutes later by Retinomax autorefraction. Subsequently, 1% atropine daily was instilled over 3 days in both eyes of the same subjects. Refractive error was re-measured on Day 3. Eyes with <2.00 D SE hyperopia on Day 3 were excluded.

Results: : Mean right eye SE refractive error with atropine was +3.39 D (s.d.± 0.85 D; range +2.25 D to +6.00 D). Similar results were found in left eyes. On average, an additional +0.43 D of hyperopia were detected on Day 3 with atropine (s.d. +0.29 D; range -0.13 D to +1.5 D) when compared to Day 1 with cyclopentolate for all eyes. Using a generalized estimating equation model to account for intereye correlation, the increase in SE hyperopia measured with atropine was statistically significant (p<0.0001). The increase in hyperopia with atropine was significant in both right and left eyes, in both younger children (6-30 months old: p=0.004, right eye; p=0.002, left eye) and older children (48-72 months old: p=0.0002, right eye; p=0.003, left eye). There was no significant difference between the amount of hyperopia measured with atropine in older children, and that in younger children (p=0.31, right eye; p=0.87, left eye; Wilcoxon rank sum test).

Conclusions: : Atropine cycloplegia results in a higher estimate of hyperopic refractive error than cyclopentolate in young children with moderate hyperopia. However, the mean SE difference is <0.50D. Considering the practical advantages of cyclopentolate over atropine, this clinically minor effect supports the use of cyclopentolate as the standard cycloplegic agent for both routine clinical use and epidemiologic research.

Keywords: hyperopia • refraction • accomodation 
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