1Kotliar K. E., 2Vilser W., 1Lanzl I. M.

1Eye Clinic, Munich University of Technology, Ismaninger Str. 22, Munich; 2Ilmenau University of Technology, G.-Kirchhoff-Str.1, Ilmenau, Germany

Background: Neosynephrine 10% , a sympatomimetic agent, is widely used to induce mydriasis in ophthalmology. It also acts as a potent vasoconstrictor as can be seen by vessel blanching of the conjunctiva. The aim of his study was to determine, whether a single drop of topical neosynephrine 10% is able to influence retinal branch artery diameter.
Methods: The diameter of retinal branch veins after neosynephrine10% application was assessed in 30 young healthy volunteers by means of Retinal Vessel Analyzer (RVA). The changes in vessel diameter were observed for 28 minutes after application. Every 2 minutes pulse and systemic blood pressure were assessed as well.
Results: A raise of mean systemic blood pressure of about 5 mmHg could be observed within 6 minutes of eye drop application. Blood pressure later returned to baseline values. Compared to baseline no significant change of branch arterial diameter could be observed. In 5 volunteers a dilation of more than 4% could be demonstrated and in 2 volunteers a constriction of more than 4% was observed.
Discussion: The diameter of retinal branch arteries did not change significantly after drug application. A small, however significant raise in mean systemic blood pressure was demonstrated. The raise in systemic blood pressure occurs rather fast after neosynephrine 10% application, which could be a sign for the systemic absorption of the drug. The thus induced blood pressure change might be too insignificant however to cause a change in retinal artery diameter as a local autoregulatory response in most individuals. Few volunteers showed a slight arterial diameter dilation which could represent a need for retinal autoregulation in those individuals.

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