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Alternative mydriasis techniques for retinopathy of prematurity screening

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Abstract

Purpose

There is a large variation in mydriatic regimens used in screening for retinopathy in preterm infants. Except for the standard instillation of mydriatic drops in their commercial formulation, other techniques for pupil dilation have also been described. This study aimed to review all techniques that have been used for mydriasis in retinopathy of prematurity eye examination (ROPEE) screening.

Methods

A comprehensive literature search was performed in PubMed, Cochrane library, Trip database, and Scopus, using the key words: “mydriasis”, “techniques”, “mydriatics”, “dilating drops”, “retinopathy of prematurity”, “ROP”, “phenylephrine”, “cyclopentolate”, “tropicamide”, “smaller mydriatic drops”, “reduction in drop size” to February 2019.

Results

Five primary studies were included, assessing the techniques of microdrops, lower conjunctival fornix (LCF) packing and Mydriasert® ophthalmic insert. Reported efficacy was similar to commercial eyedrops instillation. Microdrops appeared to have a superior safety profile. LCF packing and Mydriasert lead to increased blood pressure, without serious complications, necessitating further safety studies.

Conclusions

Of all alternative mydriasis techniques for ROPEE screening that have been described, microdrops appear to be the safest yet still effective technique in the fragile population of premature infants in risk of ROP.

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References

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Funding

The authors received no financial support for this submission.

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Authors and Affiliations

  1. 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, N. Efkarpia, 56429, Thessaloniki, Greece

    Aikaterini K. Seliniotaki, Efthymia Prousali, Nikolaos Ziakas & Asimina Mataftsi

  2. 2nd Department of Neonatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Maria Lithoxopoulou & Vasiliki Soubasi

  3. Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Stamatia Kokkali

Authors
  1. Aikaterini K. Seliniotaki
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  2. Efthymia Prousali
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  3. Maria Lithoxopoulou
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  4. Stamatia Kokkali
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  5. Nikolaos Ziakas
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  6. Vasiliki Soubasi
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  7. Asimina Mataftsi
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Contributions

All authors have made substantive intellectual contributions to this study. All authors (AKS, EP, ML, SK, NZ, VS and AM) contributed to the conceptualization of the manuscript, overview of literature and interpretation of data. AKS and AM contributed to the design of this work. AKS, AM, EP and ML contributed to data acquisition and extraction. AKS, AM, EP prepared the draft manuscript of this review. EP, AKS, AM prepared the methodological quality assessment. All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Asimina Mataftsi.

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Seliniotaki, A.K., Prousali, E., Lithoxopoulou, M. et al. Alternative mydriasis techniques for retinopathy of prematurity screening. Int Ophthalmol 40, 3613–3619 (2020). https://doi.org/10.1007/s10792-020-01542-x

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