Influences of Cycloplegia with Topical Atropine on Ocular Higher-Order Aberrations

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• 作者：Takahiro Hiraoka ; MD¹ ; ^{thiraoka@md.tsukuba.ac.jp} ; Kazunori Miyata ; MD² ; Yasuko Nakamura ; MD² ; Takashi Miyai ; MD² ; Miyuki Ogata ; COT² ; Fumiki Okamoto ; MD¹ ; Tetsuro Oshika ; MD¹
• 刊名：Ophthalmology
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：120
• 期：1
• 页码：8-13
• 全文大小：316 K

文摘

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Purpose

To investigate the influence of cycloplegia with topical atropine on higher-order aberrations (HOAs) of the eye in children.

Design

Prospective, noncomparative study.

Participants

Twenty-three eyes of 23 subjects (11 boys and 12 girls) with hyperopia, ranging in age from 3 to 12 years (average, 5.74 years), were enrolled in this study.

Methods

Refraction and wavefront aberration were evaluated before and after cycloplegia with topical instillation of 1 % atropine solution administered twice daily for 1 week. Ocular and corneal HOAs were measured simultaneously, and individual Zernike components were analyzed for a 6-mm pupil up to the 6th order. All these parameters were compared before and after cycloplegia.

Main Outcome Measures

Ocular and corneal HOAs before and after cycloplegia.

Results

Cycloplegia with topical atropine significantly increased spherical equivalent refraction from +1.92¡À1.53 diopters (D) to +3.10¡À1.61 D (P<0.01, paired t test). Ocular HOAs significantly increased from 0.282¡À0.086 ¦Ìm to 0.316¡À0.087 ¦Ìm for coma-like aberrations (P = 0.02), from 0.169¡À0.058 ¦Ìm to 0.192¡À0.076 ¦Ìm for spherical-like aberrations (P = 0.02), and from 0.333¡À0.093 ¦Ìm to 0.377¡À0.095 ¦Ìm for total HOAs (P = 0.01). Corneal HOAs did not change after cycloplegia. As for individual Zernike components, significant changes were found in C₃¹ and C₄⁰ after cycloplegia (P<0.05). The induced changes in C₄⁰ were correlated significantly with those in spherical equivalent refraction (Pearson's correlation coefficient, R = 0.45; P = 0.03).

Conclusions

Cycloplegia with atropine induced significant hyperopic shift and increases in ocular HOAs in children, leading to reduction in optical quality of the eye. It may be that physiologic tonic accommodation plays a role in improving retinal image quality by decreasing HOAs and refractive errors.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.