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The effect of atropine used in dobutamine stress echocardiography on pupil diameter
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  • Dimitrios Soulis,
  • Theodore Papaioannou,
  • Maria Zozolou,
  • Stella Daskalopoulou,
  • Charalampos Vlachopoulos,
  • Dimitrios Bethanis,
  • Dimitrios Triantafyllou
Dimitrios Soulis
Kosmoiatriki Medical Diagnostic Centre

Corresponding Author:[email protected]

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Theodore Papaioannou
National and Kapodistrian University of Athens
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Maria Zozolou
Athens Vision Eye Institute
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Stella Daskalopoulou
McGill University Faculty of Medicine
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Charalampos Vlachopoulos
National and Kapodistrian University of Athens
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Dimitrios Bethanis
Kosmoiatriki Medical Diagnostic Centre
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Dimitrios Triantafyllou
Kosmoiatriki, Medical Diagnostic Centre
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Abstract

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.