Comparing efficacies of 0.5% apraclonidine with 4% cocaine in the diagnosis of horner syndrome in pediatric patients.

Abstract

PURPOSE:

The aim of this study was to compare the efficacy of 0.5% apraclonidine with that of 4% cocaine and to evaluate its safety in the diagnosis of Horner syndrome in pediatric patients.

METHODS:

This was a randomized, crossover study, wherein 10 patients with a probable diagnosis of Horner syndrome were assigned to undergo pharmacological testing with 4% cocaine and 0.5% apaconidine. The difference in the pupil diameters of each eye was recorded under dim light before and 1 h after 0.5% apraclonidine or 4% cocaine was instilled. Any adverse effects were noted during examination or reported by the patients' parents were recorded.

RESULTS:

The mean differences in pupil diameter before and after 4% cocaine testing were -2.08 and -2.97 mm, respectively (P = 0.0047). All patients had an anisocoria greater than 1 mm after 4% cocaine testing. The mean difference in pupil diameter before and after 0.5% apraclonidine was instilled were -2.04 and +1.08 mm, respectively (P = 0.005). All patients showed a reversal of anisocoria after 0.5% apraclonidine testing. Conjunctival hyperemia was noted in 2 patients, but systemic adverse effects were not noted during examination nor reported by the patients' parents.

CONCLUSIONS:

The application of 0.5% apraclonidine in pediatric patients is safe and effective in the diagnosis of Horner syndrome.

• Authors: Po-Liang Chen, Jiann-Torng Chen, Da-Wen Lu, Yo-Chang Chen, Chih-Hsien Hsiao
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 22 Issue 3 Pg. 182-7 (Jun 2006) ISSN: 1080-7683 [Print] United States
• PMID: 16808679 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• apraclonidine
• Cocaine
• Clonidine

Topics

• Adolescent
• Child
• Child, Preschool
• Clonidine (adverse effects, analogs & derivatives)
• Cocaine (adverse effects)
• Cross-Over Studies
• Female
• Horner Syndrome (diagnosis)
• Humans
• Infant
• Male
• Pupil (drug effects)