Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease

Neill R Graff Radford, Siong Chi Lin, Paul W. Brazis, James P. Bulling, Thomas J. Liesegang, John A Lucas, Ryan J. Uitti, Peter C. O'Brien

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To evaluate the mydriatic effect of tropicamide eyedrops as a diagnostic test for Alzheimer's disease. Material and Methods: In a double- blind, placebo-controlled study, we assessed pupillary responses in 22 normal control subjects, 23 patients with probable Alzheimer's disease, 4 patients with isolated memory difficulty, and 6 patients with non-Alzheimer's dementia. Three separate studies were performed, the second and third on a subset of the original group. With use of infrared binocular pupillography, after 5 minutes of dark adaptation, we averaged pupil size during a 1-minute interval for baseline determinations. We then instilled 0.01% tropicamide into one eye. In the first two studies, we averaged pupil size for a 1- minute period at 5-minute intervals for 30 minutes, followed by a pupil light reflex test. In the third study, we measured pupil size every 5 minutes for 45 minutes and omitted the light reflex test. Results: No significant difference was noted in pupil dilatation between normal subjects and patients with Alzheimer's disease and between patients with non-Alzheimer's dementias and the Alzheimer's disease group in all three studies. Furthermore, on reperformance of the test in the same patients, more than 50% changed from a group above or below 13% pupil dilatation (a cutoff reported tO distinguish Alzheimer's disease from normal control subjects) to the opposite group. Conclusion: Results of this study indicate that pupil measurement after instillation of tropicamide cannot be used as a reliable diagnostic test for Alzheimer's disease. Moreover, test-retest reliability with use of dilute tropicamide eyedrops is questionable.

Original languageEnglish (US)
Pages (from-to)495-504
Number of pages10
JournalMayo Clinic Proceedings
Volume72
Issue number6
StatePublished - 1997

Fingerprint

Tropicamide
Ophthalmic Solutions
Pupil
Alzheimer Disease
Routine Diagnostic Tests
Reflex
Dementia
Dilatation
Mydriatics
Dark Adaptation
Light
Reproducibility of Results
Placebos

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Graff Radford, N. R., Lin, S. C., Brazis, P. W., Bulling, J. P., Liesegang, T. J., Lucas, J. A., ... O'Brien, P. C. (1997). Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease. Mayo Clinic Proceedings, 72(6), 495-504.

Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease. / Graff Radford, Neill R; Lin, Siong Chi; Brazis, Paul W.; Bulling, James P.; Liesegang, Thomas J.; Lucas, John A; Uitti, Ryan J.; O'Brien, Peter C.

In: Mayo Clinic Proceedings, Vol. 72, No. 6, 1997, p. 495-504.

Research output: Contribution to journalArticle

Graff Radford, NR, Lin, SC, Brazis, PW, Bulling, JP, Liesegang, TJ, Lucas, JA, Uitti, RJ & O'Brien, PC 1997, 'Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease', Mayo Clinic Proceedings, vol. 72, no. 6, pp. 495-504.
Graff Radford, Neill R ; Lin, Siong Chi ; Brazis, Paul W. ; Bulling, James P. ; Liesegang, Thomas J. ; Lucas, John A ; Uitti, Ryan J. ; O'Brien, Peter C. / Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease. In: Mayo Clinic Proceedings. 1997 ; Vol. 72, No. 6. pp. 495-504.
@article{c2daef63b9e642e49140f7385b8f3ffe,
title = "Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease",
abstract = "Objective: To evaluate the mydriatic effect of tropicamide eyedrops as a diagnostic test for Alzheimer's disease. Material and Methods: In a double- blind, placebo-controlled study, we assessed pupillary responses in 22 normal control subjects, 23 patients with probable Alzheimer's disease, 4 patients with isolated memory difficulty, and 6 patients with non-Alzheimer's dementia. Three separate studies were performed, the second and third on a subset of the original group. With use of infrared binocular pupillography, after 5 minutes of dark adaptation, we averaged pupil size during a 1-minute interval for baseline determinations. We then instilled 0.01{\%} tropicamide into one eye. In the first two studies, we averaged pupil size for a 1- minute period at 5-minute intervals for 30 minutes, followed by a pupil light reflex test. In the third study, we measured pupil size every 5 minutes for 45 minutes and omitted the light reflex test. Results: No significant difference was noted in pupil dilatation between normal subjects and patients with Alzheimer's disease and between patients with non-Alzheimer's dementias and the Alzheimer's disease group in all three studies. Furthermore, on reperformance of the test in the same patients, more than 50{\%} changed from a group above or below 13{\%} pupil dilatation (a cutoff reported tO distinguish Alzheimer's disease from normal control subjects) to the opposite group. Conclusion: Results of this study indicate that pupil measurement after instillation of tropicamide cannot be used as a reliable diagnostic test for Alzheimer's disease. Moreover, test-retest reliability with use of dilute tropicamide eyedrops is questionable.",
author = "{Graff Radford}, {Neill R} and Lin, {Siong Chi} and Brazis, {Paul W.} and Bulling, {James P.} and Liesegang, {Thomas J.} and Lucas, {John A} and Uitti, {Ryan J.} and O'Brien, {Peter C.}",
year = "1997",
language = "English (US)",
volume = "72",
pages = "495--504",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "6",

}

TY - JOUR

T1 - Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease

AU - Graff Radford, Neill R

AU - Lin, Siong Chi

AU - Brazis, Paul W.

AU - Bulling, James P.

AU - Liesegang, Thomas J.

AU - Lucas, John A

AU - Uitti, Ryan J.

AU - O'Brien, Peter C.

PY - 1997

Y1 - 1997

N2 - Objective: To evaluate the mydriatic effect of tropicamide eyedrops as a diagnostic test for Alzheimer's disease. Material and Methods: In a double- blind, placebo-controlled study, we assessed pupillary responses in 22 normal control subjects, 23 patients with probable Alzheimer's disease, 4 patients with isolated memory difficulty, and 6 patients with non-Alzheimer's dementia. Three separate studies were performed, the second and third on a subset of the original group. With use of infrared binocular pupillography, after 5 minutes of dark adaptation, we averaged pupil size during a 1-minute interval for baseline determinations. We then instilled 0.01% tropicamide into one eye. In the first two studies, we averaged pupil size for a 1- minute period at 5-minute intervals for 30 minutes, followed by a pupil light reflex test. In the third study, we measured pupil size every 5 minutes for 45 minutes and omitted the light reflex test. Results: No significant difference was noted in pupil dilatation between normal subjects and patients with Alzheimer's disease and between patients with non-Alzheimer's dementias and the Alzheimer's disease group in all three studies. Furthermore, on reperformance of the test in the same patients, more than 50% changed from a group above or below 13% pupil dilatation (a cutoff reported tO distinguish Alzheimer's disease from normal control subjects) to the opposite group. Conclusion: Results of this study indicate that pupil measurement after instillation of tropicamide cannot be used as a reliable diagnostic test for Alzheimer's disease. Moreover, test-retest reliability with use of dilute tropicamide eyedrops is questionable.

AB - Objective: To evaluate the mydriatic effect of tropicamide eyedrops as a diagnostic test for Alzheimer's disease. Material and Methods: In a double- blind, placebo-controlled study, we assessed pupillary responses in 22 normal control subjects, 23 patients with probable Alzheimer's disease, 4 patients with isolated memory difficulty, and 6 patients with non-Alzheimer's dementia. Three separate studies were performed, the second and third on a subset of the original group. With use of infrared binocular pupillography, after 5 minutes of dark adaptation, we averaged pupil size during a 1-minute interval for baseline determinations. We then instilled 0.01% tropicamide into one eye. In the first two studies, we averaged pupil size for a 1- minute period at 5-minute intervals for 30 minutes, followed by a pupil light reflex test. In the third study, we measured pupil size every 5 minutes for 45 minutes and omitted the light reflex test. Results: No significant difference was noted in pupil dilatation between normal subjects and patients with Alzheimer's disease and between patients with non-Alzheimer's dementias and the Alzheimer's disease group in all three studies. Furthermore, on reperformance of the test in the same patients, more than 50% changed from a group above or below 13% pupil dilatation (a cutoff reported tO distinguish Alzheimer's disease from normal control subjects) to the opposite group. Conclusion: Results of this study indicate that pupil measurement after instillation of tropicamide cannot be used as a reliable diagnostic test for Alzheimer's disease. Moreover, test-retest reliability with use of dilute tropicamide eyedrops is questionable.

UR - http://www.scopus.com/inward/record.url?scp=0030792437&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030792437&partnerID=8YFLogxK

M3 - Article

VL - 72

SP - 495

EP - 504

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 6

ER -