8Hour Survey of 001 AtropineInduced Changes in Pupil Size and Accommodative Function

Niathi Kona

Abstract

Purpose: 0.01% atropine eye drops are frequently prescribed for myopia control. However, the pharmacokinetics of topical atropine is not well understood, and current dosing regimens are not evidence-based. The aim of this study was to evaluate the effects of a single dose of 0.01% atropine on pupil size and accommodative function (biomarkers for active drug levels) over the course of 8 hours.

Methods: 12 participants received a single drop of 0.01% atropine in their non-dominant eye. Following administration of the drop, pupil diameter and accommodative amplitude were assessed every minute for the first five-minute interval, every five minutes for the subsequent 25-minute interval, and at the 1, 2, 4, and 8-hour marks. Pupil diameter was measured monocularly using an automated pupillometer (NeurOptics, Irvine, CA). Accommodative amplitude was measured monocularly via the pull-away method using 0.6M LEA symbols. Habitual refractive correction (if normally worn) was worn during accommodative testing.

Results: Measurements following atropine administration were compared to each participant's own baseline measurements. The mean time at which participants experienced their maximum change in pupil diameter was 3.5 hours (SE = 30 min). The mean magnitude of subjects' maximum change in pupil diameter was +2.93 mm (SE = 0.307 mm). The mean time at which participants experienced their maximum change in accommodative amplitude was 4.75 hours (SE = 53.4 min). The mean magnitude of subjects' maximum change in accommodative amplitude was -3.57 diopters (SE = 0.839 diopters). Compared to subjects with dark irides (n = 9), subjects with light irides (n = 3) experienced a significantly greater maximum change in pupil diameter (P < .05). There was no significant difference between light-iride and dark-iride groups with respect to the other 3 measures (P > .1).

Conclusion: Following 0.01% atropine administration, subjects typically experienced the greatest pupil dilation at the 2- or 4-hour mark, followed by some degree of recovery by the 8-hour mark. Changes in accommodative amplitude were more variable; half of the subjects experienced their most impaired accommodative function at the 8-hour mark, while the other half showed some degree of recovery by the 8-hour mark. We also found that light-iride subjects experienced increased pupil dilation compared to dark-iride subjects. Overall, our results support night-time dosing to avoid peak side effects during the day. We aim to recruit additional participants to further examine differences in responses between light-iride and dark-iride groups, particularly with respect to accommodative function.

Details

Year: 2018

Program Number: 185242

Resource Type: Scientific Program

Author Affiliation: University of California, Berkeley, School of Optometry

Co-Authors: Niathi Kona, Sarah Kochik, Sarah Kochik, Yue (Maria) Liu, Yue (Maria) Liu

Co-Author Affiliation: University of California, Berkeley, School of Optometry, University of California, Berkeley, School of Optometry, University of California, Berkeley, School of Optometry, Pacific University College of Optometry, Pacific University College of Optometry

Room: Room 304