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Risk of acute angle-closure and changes in intraocular pressure after pupillary dilation in patients with diabetes

Eye volume 37, pages 1646–1651 (2023)Cite this article

Subjects

Abstract

Background

To evaluate the risk of AAC and intraocular pressure (IOP) changes in diabetic patients after pupil dilation.

Methods

This cross-sectional study enrolled 2,287 diabetic patients among community residents in Guangzhou, China. All participants underwent routine pupil dilation unless they had a history of glaucoma. IOP was measured using a non-contact tonometer before and one hour after pupil dilation with tropicamide 0.5% and phenylephrine 0.5% eye drop. The proportion of AAC and changes in IOP after pupil dilation were evaluated.

Results

Only one of the 2,287 participants (0.04%) with diabetes developed post-dilation AAC. The mean pre and post-dilation IOP in the right was 16.1 ± 2.7 and 16.5 ± 2.8 mmHg (P < 0.001); mean pre and post-dilation IOP in the left was 16.5 ± 2.7 and 16.8 ± 2.8 mmHg (P < 0.001). Sixty-one participants (2.7%) showed an increase in IOP ≥ 5 mmHg and 25 participants (1.1%) showed a post-dilation IOP > 25 mmHg, including 11 participants (0.5%) who had both an increase in IOP ≥ 5 mmHg and post-dilation IOP > 25 mmHg. Lower pre-dilation IOP (OR = 0.827; 95% CI, 0.742–0.922; P = 0.001) and shallower anterior chamber depth (ACD) (OR = 0.226; 95% CI, 0.088–0.585; P = 0.002) were significant risk factors for an increase in IOP ≥ 5 mmHg in multivariate logistic regression analysis.

Conclusions

The risk of developing AAC after pupil dilation in diabetic patients was very low. Lower pre-dilation IOP and shallower ACD are risk factors for increased post-dilation IOP.

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Fig. 1: Distribution of anterior chamber depth and intraocular pressure in both eyes.

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Data availability

Data are available upon reasonable request.

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Acknowledgements

This study was completed using data from the Guangzhou Diabetic Eye Study. This study is a cohort study of patients with diabetes in the community, Guangzhou. Thanks very much to all the Department of Preventive Ophthalmology staff and participants in this study.

Funding

This study was supported by the National Natural Science Foundation of China (82000901), the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (303060202400362). The funding organizations had no role in the design or conduct of the study.

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Author notes

  1. These authors contributed equally: Kun Xiong, Lanhua Wang, Wangting Li.

Authors and Affiliations

  1. Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China

    Kun Xiong, Lanhua Wang, Wangting Li, Wei Wang, Jie Meng, Xia Gong, Peng Lu, Xiaoling Liang, JingJing Huang & Wenyong Huang

Authors
  1. Kun Xiong
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Contributions

Conception and design: WH, KX, WL, LW, and JH. Administrative support: WH. Provision of study materials or patients: WH. Collection and assembly of data: KX, WW. Manuscript writing: All authors. Final approval of manuscript: All authors.

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Correspondence to JingJing Huang or Wenyong Huang.

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Xiong, K., Wang, L., Li, W. et al. Risk of acute angle-closure and changes in intraocular pressure after pupillary dilation in patients with diabetes. Eye 37, 1646–1651 (2023). https://doi.org/10.1038/s41433-022-02215-y

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