Influences of cycloplegia with topical atropine on ocular higher-order aberrations.
OBJECTIVE
To investigate the influence of cycloplegia with topical atropine on higher-order aberrations (HOAs) of the eye in children.


METHODS
Prospective, noncomparative study.


METHODS
Twenty-three eyes of 23 subjects (11 boys and 12 girls) with hyperopia, ranging in age from 3 to 12 years (average, 5.74 years), were enrolled in this study.


METHODS
Refraction and wavefront aberration were evaluated before and after cycloplegia with topical instillation of 1% atropine solution administered twice daily for 1 week. Ocular and corneal HOAs were measured simultaneously, and individual Zernike components were analyzed for a 6-mm pupil up to the 6th order. All these parameters were compared before and after cycloplegia.


METHODS
Ocular and corneal HOAs before and after cycloplegia.


RESULTS
Cycloplegia with topical atropine significantly increased spherical equivalent refraction from +1.92±1.53 diopters (D) to +3.10±1.61 D (P<0.01, paired t test). Ocular HOAs significantly increased from 0.282±0.086 μm to 0.316±0.087 μm for coma-like aberrations (P=0.02), from 0.169±0.058 μm to 0.192±0.076 μm for spherical-like aberrations (P=0.02), and from 0.333±0.093 μm to 0.377±0.095 μm for total HOAs (P=0.01). Corneal HOAs did not change after cycloplegia. As for individual Zernike components, significant changes were found in C3(1) and C4(0) after cycloplegia (P<0.05). The induced changes in C4(0) were correlated significantly with those in spherical equivalent refraction (Pearson's correlation coefficient, R=0.45; P=0.03).


CONCLUSIONS
Cycloplegia with atropine induced significant hyperopic shift and increases in ocular HOAs in children, leading to reduction in optical quality of the eye. It may be that physiologic tonic accommodation plays a role in improving retinal image quality by decreasing HOAs and refractive errors.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. thiraoka@md.tsukuba.ac.jp
Takahiro
T
Hiraoka
Kazunori
K
Miyata
Yasuko
Y
Nakamura
Takashi
T
Miyai
Miyuki
M
Ogata
Fumiki
F
Okamoto
Tetsuro
T
Oshika
D057128:Aberrometry; D000065:Accommodation, Ocular / Q000187:drug effects*; D000287:Administration, Topical; D001285:Atropine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology*; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
D009184:Mydriatics; D001285:Atropine