The effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness_Chinese Journal of Ocular Fundus Diseases

Authors：

WangHongxing , LiuMian , YuGuangwei , 刘巨平 , 张琰 ,  李筱荣

Beijing Chuiyangliu Hospital Affiliated with Tsinghua University, Beijing 100022, China;

Corresponding author：

李筱荣, Email: xiaorli@163.com

Keywords：

Retinal vessels/physiopathology; Macula lutea/physiopathology; Epinephrine/toxicity; Retinal perforations/surgery

DOI：

10.3760/cma.j.issn.1005-1015.2015.06.014

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Objective To observe the effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness. Methods A prospective control study. 32 eyes of 32 patients with macular hole who underwent vitrectomy were enrolled in this study. The patients including 14 males (14 eyes) and 27 females (18 eyes), with the average age of (64.0±4.5)years. Uncorrected visual acuity, corrected visual acuity, slit lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography and optical coherence tomography were performed in all patients. Retinal vascular caliber located in 0.5-1.0 disc diameter from optic disk was measured from digital fundus photographs and summarized as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 1 month, 3 months follow-up visit. The macular thickness is the distance from retinal interface of inner plexiform layer to retinal pigment epithelium layer. The macula was divided into inner ring ( < 3 mm) and outer ring (3-6 mm) according to the distance from the fovea. The patients were divided into experiment group (include epinephrine in intraocular irrigation solution, 1:1000) and control group (without epinephrine in intraocular irrigation solution), 16 eyes in each group. The difference of CRAE and CRVE between two groups was not significant (P > 0.05). The difference of macular thickness between inner ring and outer ring was not significant (P > 0.05). The average follow-up was 3.5 months. CRAE, CRVE and macular thickness in inner ring and outer ring before and 1 month, 3 months after surgery were comparatively analyzed. Results The differences of CRAE and CRVE before and 1, 3 months after surgery both in experiment group (t_CRAE=0.322, 0.148; t_CRVE=0.317, 0.005) and control group (t_CRAE=0.226, 0.137; t_CRVE=0.284, 0.151) were not significant (P > 0.05). The differences of CRAE (t=0.624, 0.424) and CRVE (t=0.015, 0.041) between experiment group and control group also were not significant (P > 0.05). The differences of macular thickness in inner ring and outer ring before and 1, 3 months after surgery both in experiment group (t_inner=0.322, 0.148;t_outer=0.317, 0.005) and control group (t_inner=0.226, 0.137;t_outer=0.284, 0.151) were not significant (P > 0.05). The differences of macular thickness in inner ring (t=1.568, 0.373) and outer ring (t=-1.697, 0.536) between experiment group and control group also were not significant (P > 0.05). Conclusion Epinephrine (1:1000) in intraocular irrigation solution has no effect on retinal vascular caliber and macular thickness in patients with macular hole.

Citation： WangHongxing, LiuMian, YuGuangwei. The effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness. Chinese Journal of Ocular Fundus Diseases, 2015, 31(6): 567-570. doi: 10.3760/cma.j.issn.1005-1015.2015.06.014 Copy

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2.	Kim EC, Park SH, Kim MS. A comparison of pupil dilation and induction of corneal endothelial apoptosis by intracameral 1% lidocaine versus 1:100, 000 epinephrine in rabbits[J].J Ocul Pharmacol Ther, 2010, 26(6):563-570.
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4.	Sun C, Wang JJ, Mackey DA, et al. Retinal vascular caliber: systemic, vironmental, and genetic associations[J].Surv Ophthalmol, 2009, 54(1):74-95.
5.	Wickremasinghe SS, Rogers SL, Gillies MC, et al. Retinal vascular caliber changes after intravitreal triamcinolone treatment for diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2008, 49(11):4707-4711.
6.	Wickremasinghe SS, Busija L, Guymer RH, et al. Retinal venular caliber predicts visual outcome after intravitreal ranibizumab injection treatments for neovascular AMD [J]. Invest Ophthalmol Vis Sci, 2012, 53(1):37-41.
7.	刘巨平, 李筱荣.视网膜血管管径测量及其应用进展[J].中国实用眼科杂志, 2011, 29(6):532-536.
8.	Nguyen TT, Islam FM, Farouque HM, et al. Retinal vascular caliberand brachial flow-mediated dilation: the Multi-Ethnic Study of Atherosclerosis [J].Stroke, 2010, 41(7):1343-1348.
9.	Wong TY, Islam FM, Klein R, et al. Retinal vascular caliber, cardiovascular risk factors, and inflammation: the multi-ethnic study of atherosclerosis (MESA)[J]. Invest Ophthalmol Vis Sci, 2006, 47(6):2341-2350.
10.	Tirsi A, Duong M, Tsui W, et al.Retinal vessel abnormalities as a possible biomarker of brain volume loss in obese adolescents[J]. Obesity(Silver Spring), 2013, 21(12):577-585.
11.	Ikram MK, Cheung CY, Lorenzi M, et al. Retinal vascular caliber as a biomarker for diabetes microvascular complications[J].Diabetes Care, 2013, 36(3):750-759.
12.	Poletti E, Grisan E, Ruggeri A.Image-level tortuosity estimation in wide-field retinal lmages from infants with Retinopathy of Prematurity[J].Conf Proc IEEE Eng Med Biol Soc, 2012, 2012:4958-4961.
13.	Cheung CY, Ong S, Ikram MK, et al.Retinal vascular fractal dimension is associated with cognitive dysfunction[J].J Stroke Cerebrovasc Dis, 2014, 23(1):43-50.
14.	Cakmak HB, Cagil N, Dal D, et al.Effects of intracameral use of adrenalin solution with preservative on corneal endothelium[J].Cutan Ocul Toxicol, 2010, 29(1):41-49.
15.	Sander B, Thornit DN, Colmorn L, et al. Progression of diabetic macular edema: correlation with blood retinal barrier permeability, retinal thickness, and retinal vessel diameter[J]. Invest Ophthalmol Vis Sci, 2007, 48(9):3983-3987.

1. Bozkurt E, Yazici AT, Pekel G, et al.Effect ofintracameral epinephrine use on macular thickness after uneventful phacoemulsification[J]. J Cataract Refract Surg, 2010, 36(8):1380-1384.
2. Kim EC, Park SH, Kim MS. A comparison of pupil dilation and induction of corneal endothelial apoptosis by intracameral 1% lidocaine versus 1:100, 000 epinephrine in rabbits[J].J Ocul Pharmacol Ther, 2010, 26(6):563-570.
3. Pong JC, Tang WW, Lai JS.Toxic endothelial cell destruction syndrome after intraocular lens repositioning with intracameral epinephrine[J]. J Cataract Refract Surg, 2008, 34(11):1990-1991.
4. Sun C, Wang JJ, Mackey DA, et al. Retinal vascular caliber: systemic, vironmental, and genetic associations[J].Surv Ophthalmol, 2009, 54(1):74-95.
5. Wickremasinghe SS, Rogers SL, Gillies MC, et al. Retinal vascular caliber changes after intravitreal triamcinolone treatment for diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2008, 49(11):4707-4711.
6. Wickremasinghe SS, Busija L, Guymer RH, et al. Retinal venular caliber predicts visual outcome after intravitreal ranibizumab injection treatments for neovascular AMD [J]. Invest Ophthalmol Vis Sci, 2012, 53(1):37-41.
7. 刘巨平, 李筱荣.视网膜血管管径测量及其应用进展[J].中国实用眼科杂志, 2011, 29(6):532-536.
8. Nguyen TT, Islam FM, Farouque HM, et al. Retinal vascular caliberand brachial flow-mediated dilation: the Multi-Ethnic Study of Atherosclerosis [J].Stroke, 2010, 41(7):1343-1348.
9. Wong TY, Islam FM, Klein R, et al. Retinal vascular caliber, cardiovascular risk factors, and inflammation: the multi-ethnic study of atherosclerosis (MESA)[J]. Invest Ophthalmol Vis Sci, 2006, 47(6):2341-2350.
10. Tirsi A, Duong M, Tsui W, et al.Retinal vessel abnormalities as a possible biomarker of brain volume loss in obese adolescents[J]. Obesity(Silver Spring), 2013, 21(12):577-585.
11. Ikram MK, Cheung CY, Lorenzi M, et al. Retinal vascular caliber as a biomarker for diabetes microvascular complications[J].Diabetes Care, 2013, 36(3):750-759.
12. Poletti E, Grisan E, Ruggeri A.Image-level tortuosity estimation in wide-field retinal lmages from infants with Retinopathy of Prematurity[J].Conf Proc IEEE Eng Med Biol Soc, 2012, 2012:4958-4961.
13. Cheung CY, Ong S, Ikram MK, et al.Retinal vascular fractal dimension is associated with cognitive dysfunction[J].J Stroke Cerebrovasc Dis, 2014, 23(1):43-50.
14. Cakmak HB, Cagil N, Dal D, et al.Effects of intracameral use of adrenalin solution with preservative on corneal endothelium[J].Cutan Ocul Toxicol, 2010, 29(1):41-49.
15. Sander B, Thornit DN, Colmorn L, et al. Progression of diabetic macular edema: correlation with blood retinal barrier permeability, retinal thickness, and retinal vessel diameter[J]. Invest Ophthalmol Vis Sci, 2007, 48(9):3983-3987.

Chinese Journal of Ocular Fundus Diseases

The effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness

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