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E. Rechtman, A. Harris, A. Leys, J. Moisseiev, J. Van Calster, J. Glovinsky, I. Stalmans; The Effects of Pupil Dilation on Intraocular Pressure and Ocular Pulse Amplitude in Patients With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2104.
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To assess the effects of pupil dilation on intraocular and ocular pulse pressures (IOP & OPA, respectively) in eyes with age-related macular degeneration (AMD).
This assessment is part of a bi-center prospective study (Sheba Medical Center, Israel and University Hospitals Leuven, Belgium), evaluating the effect of intravitreal bevacizumab treatment on IOP/OPA. After signing an informed consent, all patients have been examined 3 times: At days 0 (prior to injection), 7(± 3) and 30 (± 7) post injection. At each visit, pre and post pupil dilation (tropicamide 1% ± phenylephrine 10%) IOP/OPA of both eyes were measured, using the Dynamic Contour Tonometer (DCT, Pascal; Swiss Microthecnology AG, Prt, Switzerland). Each time, up to 3 DCT measurements were performed to reach a test with good quality (quality 1-2 out of 5, best tests taken for calculation). Paired t test between pre and post pupil dilation IOP/OPA was preformed in all exams.
Thirty five neovascular AMD patients (21 females, age 79 ± 5.9 years (mean ±SD)) were recruited. Mean±SD axial length was 23.37±0.96mm (study eye) and 23.44±1.13mm (fellow eye), while mean±SD central corneal thickness was 550.8±38.2µm (study eye) and 549.5±40.8µm (fellow eye). A total of 746 DCT measurements were performed and final mean DCT test quality was 2. Pre and post pupil dilation IOP/OPA (mean±SD) were 15.3±2.9mmHg/2.3±1mmHg versus 15.5±3.3mmHg/2.5±1mmHg in the study eye, and 15.8±3.4mmHg/2.5±0.9mmHg versus 16.2±3.5mmHg/2.5±1mmHg in the fellow eye. There were no statistically significant differences between any of the parameters pre and post pupil dilation.
Overall, in this elderly population with neovascular AMD, nor IOP neither OPA (a results of IOP fluctuations according to the cardiac cycle and which mostly comes from the choroidal circulation) were significantly altered by pupil dilation.
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