The acute effect of atropine eye drops on the human full-field electroretinogram
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ORIGINAL RESEARCH ARTICLE
The acute effect of atropine eye drops on the human full-field electroretinogram Safal Khanal
. Sachi Nitinkumar Rathod . John R. Phillips
Received: 11 June 2020 / Accepted: 17 November 2020 Ó Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Atropine eye drops are a common and effective treatment for slowing myopia progression, but the site and mode of action of atropine in controlling myopia are unclear. We investigated the early retinal sites of action of atropine by examining its effects on the human full-field electroretinogram (ffERG). Method Baseline ffERGs were recorded in both eyes of 24 healthy subjects (mean ± SD: 21.0 ± 2.3 years; spherical equivalent refraction, range: ? 1.63 to - 0.75 D) using 6 standard ISCEV protocols, 30 min after bilateral pupil dilation with 1% Tropicamide. Atropine (1 drop, 0.1%) was then instilled into the non-dominant eye. 24 h later, ffERGs were again recorded in both eyes. Ratios (postS. Khanal S. N. Rathod J. R. Phillips (&) Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand e-mail: [email protected] S. Khanal e-mail: [email protected] Present Address: S. Khanal School of Optometry, The University of Alabama At Birmingham, Birmingham, AL 35294, USA J. R. Phillips Department of Optometry, Asia University, Taichung, Taiwan
atropine: pre-atropine) of dark-adapted (DA) and light-adapted (LA) ffERGs were compared between atropine-treated and control eyes using multivariate repeated measures general linear models. Results Atropine-treated eyes responded with 14% lower DA3.0 OP (oscillatory potential) amplitude (p = 0.003) and 4% delay in the DA10.0 a-wave peak time (p = 0.00099) compared with control eyes. Amplitudes and peak times were not different between atropine-treated and control eyes for DA0.01, LA3.0, and LA3.0 flicker ERGs. While atropine caused a small (1.26 mm2, p = 0.03) extra increase in pupil area in the treated eye, atropine-induced changes in ffERG responses bore no relationship with changes in pupil area (R2 = 2–5%, p [ 0.05). Conclusions The observed changes in oscillatory potentials corroborate previous findings that atropine affects neural activity in the inner retina. However, observed changes to the a-wave suggest that atropine also affects activity in photoreceptors. Keywords Atropine Electrophysiology Myopia Photoreceptors Retina
Introduction Myopia has evolved as a major public health issue and socio-economic burden because of its rapid rise in
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global prevalence [1], the associated risks of sightthreatening pathologies [2, 3], and the detrimental effects of uncorrected myopia on educational achievement [4] and productivity [5] in the developing world. Some initiatives are being implemented in schools to reduce myopia incidence [6, 7], and methods for slowing the progression of myopia in those who develop it are also being developed [8, 9]. Even reducing
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