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Title: Perimetric changes related to three different interventions, which reverse the miotic effect of pilocarpine [Cambios perim�tricos relacionados a tres diferentes intervenciones que se contraponen al efecto de miosis inducido por pilocarpina]
Author: Paczka, J.A.
de Los Rios-Obregon, D.
Valle, D.
Merikansky, A.
Issue Date: 2010
Abstract: Objective: To assess the effect of perimetric values of three different interventions used to reverse pupillary constriction induced by pilocarpine. Methods: A prospective study was performed on 24 eyes of 24 glaucoma patients receiving 2% pilocarpine therapy. Serial visual field testing at fixed time intervals was performed under pilocarpine effect and during three other conditions planned to counteract miosis: 1) Forty-eight hours after pilocarpine suspension, 2) thirty minutes after 10% phenilephrine instillation, and 3) thirty minutes after 1% tropicamide administration. Pupillary diameter and several perimetric parameters were compared among interventions. Results: Pupil diameter with pilocarpine was significantly smaller (ANOVA; p < 0.05) as compared with the other situations; in addition, that parameter was significantly larger with tropicamide (p < 0.05) as compared with the rest. Perimetry index, mean deviation (MD) under pilocarpine effect (-8.1 � 2.1 dB) was considerably worse (p < 0.05) as compared with the remaining conditions (6.4 � 2.3 dB, 5.4 � 2.2 dB, 5.3 � 2.3 dB, respectively). Foveal threshold significantly increased by tropicamide application before visual field testing (p < 0.05) as compared with the moment when pilocarpine had been used. Conclusions: These findings suggest that active pupillary changes in glaucoma patients produce significant differences on some perimetric variables, although these differences may not be clinically significant. � 2010 Sociedad Mexicana de Oftalmolog�a.
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