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Systemic effects of ophthalmic cyclopentolate on body weight in neonatal mice
Nicole A Rozette1, Suraporn Matragoon, Shivani Sethi
1Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, Ga., USA.
Insights
Cyclopentolate eye drops are absorbed systemically in neonates and can lead to decreased weight gain, suggesting a potential risk for feeding intolerance. Further studies are needed for neonatal patients.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Pharmacology
Background:
- Cyclopentolate is routinely used in neonates for retinopathy of prematurity screening.
- Concerns exist regarding potential systemic effects and feeding intolerance after ophthalmic administration.
Purpose of the Study:
- To measure systemic cyclopentolate concentrations post-ophthalmic administration.
- To assess weight changes as an indicator of feeding alterations in a neonatal model.
Main Methods:
- Neonatal mice received ophthalmic drops (cyclopentolate, placebo, or saline).
- Systemic cyclopentolate levels were measured via serum samples.
- Daily weights were recorded for 7 days post-administration.
Main Results:
- Systemic cyclopentolate was detected in serum at 30 minutes, 1 hour, and 24 hours post-administration.
- The cyclopentolate group showed significantly less weight gain on days 3 and 7 compared to the placebo group.
Conclusions:
- Cyclopentolate is systemically absorbed following ophthalmic instillation.
- Cyclopentolate administration in neonatal mice resulted in decreased weight gain.
- These preclinical findings warrant further investigation in neonatal patients.
Background:
Cyclopentolate is standardly used in ophthalmologic examinations of neonates to facilitate screening for retinopathy of prematurity. Reports of systemic effects have raised concerns of an increased risk of feeding intolerance after the examinations.
Objectives:
The goal of this study was to evaluate systemic concentrations of cyclopentolate after ophthalmic administration, as well as assess changes in weight as an indirect measure of alteration in feeding.
Methods:
Neonatal mice were randomized into three groups to simulate a neonatal model for ophthalmic medication administration. The cyclopentolate group received a one-time administration of tetracaine, cyclopentolate, and phenylephrine ophthalmologic solutions in accordance with the protocol used at the children's hospital. The placebo group received the same ophthalmic drop administration, except for normal saline in place of cyclopentolate, and the control group received no ophthalmic drops and minimal handling. Daily weights and serum samples to measure systemic concentrations of cyclopentolate post-ophthalmic administration were assessed at baseline and for 7 days following drop administration.
Results:
Analysis of serum levels demonstrated detectability of systemic cyclopentolate after ophthalmic administration as early as 30 min (86 ng/ml), 1 h (60 ng/ml), and 24 h (6.2 ng/ml). There were also differences in weight gained on following ophthalmic administration observed between the cyclopentolate group and placebo group, with the cyclopentolate group weighing significantly less on days 3 and 7 (p = 0.02).
Conclusions:
RESULTS indicate cyclopentolate is absorbed systemically and instillation of cyclopentolate decreases weight gain in neonatal mice compared to placebo. These preclinical findings provide rationale for further studies in neonatal patients.
