This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Koc, F Articles by Firat, E Search for Related Content PubMed PubMed Citation Articles by Koc, F Articles by Firat, E Topic Collections Relevant Article

The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis

¹ SB Ulucanlar Eye Hospital, Neuro-ophthalmology Unit, Ankara, Turkey
² Hacettepe University Faculty of Medicine, Department of Neurology, Neuro-ophthalmology Unit, Ankara, Turkey

Correspondence to:
Correspondence to:
Dr Feray Koc
Kuzgun sok 48/3 Asagi Ayranci, Ankara 06540, Turkey; dr_feray{at}yahoo.com

ABSTRACT
Aims: To evaluate the sensitivity and specificity of 0.5% apraclonidine test in the diagnosis of oculosympathetic paresis (OSP).

Method: Apraclonidine (0.5%) was administered to 31 eyes, nine with a diagnosis of Horner syndrome (HS), 22 with bilateral OSP caused by diabetes, and to 54 control eyes. All were confirmed with the cocaine test. The effects on pupil diameter and upper eyelid level were observed 1 hour later.

Results: Apraclonidine caused a mean dilation of 2.04 mm (range 1–4.5) (p<0.001) in the pupils with OSP and it caused pupillary constriction in the control eyes with a mean change of –0.14 mm (range 0.5 to –1) (p<0.05). It caused reversal of anisocoria in all HS cases. Its effects on both pupil diameters and upper lid levels differed significantly between the groups (p<0.001). The mean elevation in the upper lid was 1.75 mm (range 1–4) in the OSP group (p<0.001) and 0.61 mm (range 0–3) in the control group (p<0.001).

Conclusion: The effect of the apraclonidine (0.5%) test on the pupil diameter was diagnostic for OSP and had at least the same sensitivity and specificity as the cocaine test for the diagnosis of OSP.

Abbreviations: HS, Horner syndrome; OSP, oculosympathetic paresis

Keywords: oculosympathetic paresis; apraclonidine; Horner syndrome

Relevant Article

BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2005 89: 1389. [Extract] [Full Text] [PDF]