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The acute effect of atropine eye drops on the human full-field electroretinogram

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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 (post-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.

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Acknowledgements

The authors thank the New Zealand Association of Optometrists for a Higher Degree Research Write-up Scholarship to SK

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Safal Khanal

    Present address: School of Optometry, The University of Alabama At Birmingham, Birmingham, AL, 35294, USA

Authors and Affiliations

  1. Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand

    Safal Khanal, Sachi Nitinkumar Rathod & John R. Phillips

  2. Department of Optometry, Asia University, Taichung, Taiwan

    John R. Phillips

Authors
  1. Safal Khanal
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  2. Sachi Nitinkumar Rathod
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Contributions

Safal Khanal’s contributions included Conceptualization, Methodology, Formal analysis, Visualisation, Writing – Original Draft. Sachi Rathod’s contributions included Investigation, Data Curation, Project Administration. John Phillips’ contributions included Conceptualization, Supervision, Resources, Writing – Review and Editing.

Corresponding author

Correspondence to John R. Phillips.

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Conflict of interest

The authors declare that they have no conflict of interest or commercial relationship in relation to this work.

Consent to participate

Written informed consent was obtained from all individual participants included in the study.

Consent to publish

The authors affirm that all participants provided informed consent for publication of the study findings. The study does not report identifying information for any participants.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Human Participants Ethics Committee of the University of Auckland (ref: 017982).

Statement on the welfare of animals

No animals were used in this research.

Disclosure

This study was presented in part at the 17th International Myopia Conference, Tokyo, Japan, September 2019. Author SK was the recipient of a University of Auckland PhD scholarship funded by CooperVision Inc. Author SNR was supported by a summer research scholarship awarded by the Faculty of Medical and Health Science, University of Auckland.

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Khanal, S., Rathod, S.N. & Phillips, J.R. The acute effect of atropine eye drops on the human full-field electroretinogram. Doc Ophthalmol 142, 315–328 (2021). https://doi.org/10.1007/s10633-020-09806-8

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  • DOI: https://doi.org/10.1007/s10633-020-09806-8

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