To quantitatively evaluate the acute effects of pseudoephedrine on the macular microvasculature using optical coherence tomography angiography (OCTA).
Randomized placebo-controlled clinical study.
In this study, 60 right eyes of 60 healthy subjects were divided into 2 groups. The study group received 60 mg of pseudoephedrine and the control group received a placebo. All participants underwent OCTA at baseline and 1 h after oral intake. Superficial macular flow area, foveal avascular zone (FAZ), superficial macular vessel density, central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were analyzed.
Baseline superficial macular flow area, FAZ area, superficial macular vessel density, CFT and SFCT measurements in the study and control groups showed no significant difference (p > 0.05 for all). Oral pseudoephedrine intake caused a significant reduction in superficial macular flow area, FAZ area, superficial macular vessel density and SFCT measurements when compared with baseline (p < 0.05 for all). However, there was no significant difference in CFT after oral pseudoephedrine intake (p > 0.05).
Oral pseudoephedrine intake causes a significant decrease in superficial macular blood flow and SFCT. Impairmant of macular microcirculation can be detected noninvasively and quantitavitely by OCTA.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Laccourreye O, Werner A, Giroud JP, Couloigner V, Bonfils P, Bondon-Guitton E. Benefits, limits and danger of ephedrine and pseudoephedrine as nasal decongestants. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132:31–4.
Eccles R, Jawad MS, Jawad SS, Angello JT, Druce HM. Efficacy and safety of single and multiple doses of pseudoephedrine in the treatment of nasal congestion associated with common cold. Am J Rhinol. 2005;19:25–31.
Kanfer I, Dowse R, Vuma V. Pharmacokinetics of oral decongestants. Pharmacotherapy. 1993;13:116S-S128.
Cantu C, Arauz A, Murillo-Bonilla LM, López M, Barinagarrementeria F. Stroke associated with sympathomimetics contained in over-the-counter cough and cold drugs. Stroke. 2003;34:1667–72.
Olivier P, Dugué A, Montastruc JL. Adverse cardiovascular and central neurologic reactions to sympathomimetics used as nasal decongestants: results of the French National Pharmacovigilance Survey. Therapie. 2003;58:361–6 (in French).
Ovet G, Alpfidan I, Sakarya Y, Sakarya R, Ozcimen M, Göktaş S, et al. The acute effect of pseudoephedrine on choroidal thickness. Clin Ter. 2016;167:63–6.
Rosenfeld PJ, Durbin MK, Roisman L, Zheng F, Miller A, Robbins G, et al. ZEISS Angioplex™ spectral domain optical coherence tomography angiography: technical aspects. Dev Ophthalmol. 2016;56:18–29.
Munk MR, Giannakaki-Zimmermann H, Berger L, Huf W, Ebneter A, Wolf S, et al. OCT-angiography: a qualitative and quantitative comparison of 4 OCT-A devices. PLoS One. 2017;12:e0177059.
Spaide RF, Klancnik JM Jr, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol. 2015;133:45–50.
Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, et al. Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express. 2012;20:4710–25.
Matsunaga D, Yi J, Puliafito CA, Kashani AH. OCT angiography in healthy human subjects. Ophthalmic Surg Lasers Imaging Retina. 2014;45:510–5.
Spaide RF, Koizumi H, Pozonni MC. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol. 2008;146:496–500.
Tuncer I, Karahan E, Zengin MO, Atalay E, Polat N. Choroidal thickness in relation to sex, age, refractive error, and axial length in healthy Turkish subjects. Int Ophthalmol. 2015;35:403–10.
Cınar E, Yuce B, Zengin MO, Kucukerdonmez C. The effect of nicotine on macular microcirculation in healthy subjects. Ophthalmic Surg Lasers Imaging Retina. 2019;50:691–700.
Zengin MO, Cinar E, Kucukerdonmez C. The effect of nicotine on choroidal thickness. Br J Ophthalmol. 2014;98:233–7.
Zengin MO, Cinar E, Karahan E, Tuncer I, Kucukerdonmez C. The effect of caffeine on choroidal thickness in young healthy subjects. Cutan Ocul Toxicol. 2015;34:112–6.
Flanagan S, Minassian SL, Prokocimer P. Pharmacokinetics of tedizolid and pseudoephedrine administered alone or in combination in healthy volunteers. J Clin Med. 2018;7:150.
Rowe GG, Castillo CA, Crumpton CW, Maxwell GM. Systemic and coronary hemodynamic effects of pseudoephedrine. Proc Soc Exp Biol Med. 1965;118:682–4.
Smith CV, Rayburn WF, Anderson JC, Duckworth AF, Appel LL. Effect of a single dose of oral pseudoephedrine on uterine and fetal Doppler blood flow. Obstet Gynecol. 1990;76:803–6.
Karti O, Zengin MO, Kerci SG, Ayhan Z, Kusbeci T. Acute effect of caffeine on macular microcirculation in healthy subjects: an optical coherence tomography angiography study. Retina. 2019;39:964–71.
Ayhan Z, Kaya M, Ozturk T, Karti O, Hakan OF. Evaluation of macular perfusion in healthy smokers by using optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina. 2017;48:617–22.
Özdemir HB, Şekeroğlu MA. The effect of topical tropicamide and phenylephrine on macular and peripapillary microvasculature: an optical coherence tomography angiography study. Int Ophthalmol. 2020;40:1969–76.
Conflicts of interest
I. Tuncer, None; U. Unsal, None.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Corresponding Author: Ibrahim Tuncer
About this article
Cite this article
Tuncer, I., Unsal, U. Acute effect of pseudoephedrine on macular microcirculation in healthy subjects: an optical coherence tomography angiography study. Jpn J Ophthalmol (2021). https://doi.org/10.1007/s10384-021-00859-z
- Macular microcirculation
- Optical coherence tomography angiography
- Retinal flow