Changes in lumen width of nasolacrimal drainage system after adrenergic and cholinergic stimulation.
OBJECTIVE
To determine the effect of an adrenergic agonist and a cholinergic agonist on the lumen width of the nasolacrimal drainage system.


METHODS
Prospective, nonrandomized, clinical trial.


METHODS
The asymptomatic sides of 33 patients (23 women, 10 men) with unilateral stenosis/obstruction of the nasolacrimal drainage system were studied. The tear meniscus height of the asymptomatic side was normal, with a patent lacrimal system as revealed by dacryocystography. The nasolacrimal drainage system of the asymptomatic side was infused with 100 microL of 5% phenylephrine hydrochloride (an alpha-1 adrenoceptor agonist) or 100 microL of 2% pilocarpine hydrochloride (a cholinergic agonist), and dacryocystography was performed to determine the lumen width of the nasolacrimal drainage system.


RESULTS
Phenylephrine caused a significant increase of the lumen width of the nasolacrimal drainage system, and the changes were more marked in the nasolacrimal duct (NLD), especially the upper and middle regions, than in the lacrimal sac. In contrast, pilocarpine reduced the lumen width of the NLD significantly, especially in the middle and lower regions, and the lumen width of the lacrimal sac was not significantly changed.


CONCLUSIONS
The alterations of the lumen width of the nasolacrimal drainage system, especially the lumen width of the NLD by adrenergic and cholinergic agonists, suggest that the lumen width can be changed by the autonomic nervous system.
Narioka
Junji
J
Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan. nariokaj@m2.dion.ne.jp
Ohashi
Yuichi
Y
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018721:Muscarinic Agonists / Q000008:administration & dosage*; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000294:innervation; D010656:Phenylephrine / Q000008:administration & dosage; D010862:Pilocarpine / Q000008:administration & dosage; D011446:Prospective Studies; D011859:Radiography; D013666:Tears / Q000378:metabolism
D000316:Adrenergic alpha-Agonists; D018721:Muscarinic Agonists; D010862:Pilocarpine; D010656:Phenylephrine