Pupillary response to tropicamide in patients with Alzheimer disease.
OBJECTIVE
To determine whether pupillary responses to dilute tropicamide could be used as a diagnostic test for Alzheimer disease (AD). The authors also investigated whether concurrent use of an oral acetylcholinesterase inhibitor (tacrine) alters the pupillary response to dilute tropicamide in patients with AD, and whether pupillary responses to dilute tropicamide differ in young versus older control subjects.


METHODS
Pupillary diameter and area of both eyes were measured in light and darkness, at 10-minute intervals for 40 minutes after random instillation of 0.01% tropicamide to one eye. Four groups of subjects were studied: 9 patients with AD, 10 who were treated with tacrine, 11 older control subjects, and 10 young control subjects.


RESULTS
Mean change in anisocoria was not significantly different among groups at any of the measurement time points. Mean percent change in diameter of the treated eyes showed a trend toward faster maximum dilatation in the AD groups, but change in pupillary measurements did not identify individuals with AD.


CONCLUSIONS
Pupillary response to dilute tropicamide did not effectively distinguish individual patients with AD from young or older control subjects.
Loupe
D N
DN
Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA 30322, USA.
Newman
N J
NJ
Green
R C
RC
Lynn
M J
MJ
WIlliams
K K
KK
Geis
T C
TC
Edelhauser
H F
HF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010276:Parasympatholytics / Q000494:pharmacology; D011680:Pupil / Q000187:drug effects* / Q000502:physiology; D013619:Tacrine / Q000627:therapeutic use; D014331:Tropicamide / Q000494:pharmacology
D002800:Cholinesterase Inhibitors; D009883:Ophthalmic Solutions; D010276:Parasympatholytics; D013619:Tacrine; D014331:Tropicamide