The effect of atropine used in dobutamine stress echocardiography on
Aims The aim of this study is to investigate whether atropine when
administered in persons without glaucoma during dobutamine stress
echocardiography causes pupillary dilation. Methods and Results 144
patients referred for dobutamine stress echocardiography (DSE) study
without any history of glaucoma were observed. 39 were excluded from the
study because they did not receive atropine. Pupil diameter was measured
at the same light conditions before and after each study session. 105
patients received during DSE atropine doses from 0.1 mg to 1.25mg (most
patients received 0.25-0.75mg). For the total of 210 examined eyes pupil
diameter remained statistically unaltered after each DSE test
(3.65±0.799 mm before vs 3.63±0.766 mm after, p=0.737 respectively).
Similarly, pupil diameter remained unchanged when left and right eyes
were separately compared (Right Eye: 3.770 ± 0.812 before vs 3.752 ±
0.745 mm after, p=0.821 and Left eye: 3.521±0.770 before vs 3.499 ±
0.770 mm after, p=0.806, respectively). Diameter of right and left pupil
remained unaltered also after grouping patients by gender and iris
pigmentation. Age, weight, atropine dose and propranolol dose are not
correlated with changes in pupil diameter. Conclusion Intravenous
atropine, in usual doses administered in dobutamine stress
echocardiography, does not cause mydriasis in adults without glaucoma.
This is an indication that – though it is not currently recommended–
atropine use during DSE in patients with narrow angle glaucoma may be
potentially safe; further studies are needed to investigate this option.