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. 2021 Sep 9;16(9):e0256878.
doi: 10.1371/journal.pone.0256878. eCollection 2021.

Systemic adverse events after screening of retinopathy of prematurity with mydriatic

Shumpei Obata  1 , Taku Imamura  1 , Masashi Kakinoki  1 , Takahide Yanagi  2 , Yoshihiro Maruo  2 , Masahito Ohji  1
Affiliations

Systemic adverse events after screening of retinopathy of prematurity with mydriatic

Shumpei Obata et al. PLoS One. .

Abstract

Purpose: To evaluate systemic adverse events after screening for retinopathy of prematurity (ROP) performed with mydriatic.

Methods: This was a retrospective case series study. Medical records of consecutive patients who underwent screening for ROP with 0.5% phenylephrine and 0.5% tropicamide eyedrops were retrospectively reviewed. The score of abdominal distention (0-5), volume of milk sucked and volume of stool, along with systemic details (pulse and respiration rates, blood pressure and number of periods of apnea) were collected at 1 week and 1 day before ROP examination, and at 1 day after examination. Results were compared between the days before and after examination. Correlation between body weight at the time of examination and the score of abdominal distention was examined. The numbers of infants with abdominal and/or systemic adverse events were compared between pre- and post-examination periods.

Results: Eighty-six infants met the inclusion criteria. The score of abdominal distention increased from 2.0 at 1 day before examination to 2.3 at 1 day after examination (p = 0.005), and the number of infants who had worsened abdominal distension increased after examination (p = 0.01). Infants with lower body weight had a higher score of abdominal distention (p < 0.0001, r = -0.57). The number of infants with reduced milk consumption increased after examination (p = 0.0001), as did the number of infants with decreased pulse rate (p = 0.0008).

Conclusions: Screening for ROP with mydriatic may have adverse effects on systemic conditions. Infants should be carefully monitored after ROP screening with mydriatic.

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Conflict of interest statement

M.O. reports personal fees from Santen Pharmaceutical, unrelated to the submitted work. We used Midorin-PTM eye drop marketed by Santen Pharmaceutical, a mixture of 0.5% phenylephrine and 0.5% tropicamide, as mydriatics which is commonly used in Japan. The other authors declare that they have no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. The scores of abdominal distention from 1 week before examination to 1 day after screening for retinopathy of prematurity.
Low scores of abdominal distention represent less abdominal distention. *Statistical difference (p < 0.05, paired-t tests with Bonferroni correction).
Fig 2
Fig 2. Correlation between body weights at retinopathy of prematurity (ROP) examinations and the scores of abdominal distention.
Fig 3
Fig 3. The volume of milk sucked, per infant per day, from 1 week before examination to 1 day after examination.
*Statistical difference (p < 0.05, paired-t tests with Bonferroni correction).
Fig 4
Fig 4. The daily stool volumes measured from 1 week before examination to 1 day after examination.
*Statistical difference (p < 0.05, paired-t tests with Bonferroni correction).
Fig 5
Fig 5. Pulse rates from 1 week before examination to 1 day after examination.
*Statistical difference (p < 0.05, paired-t tests with Bonferroni correction).
Fig 6
Fig 6. Systolic and diastolic blood pressure, number of periods of apnea and respiration rates from 1 week before examination to 1 day after examination.
See this image and copyright information in PMC

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