Pupillary dilation as an index of central nervous system alpha 2-adrenoceptor activation

In recent years there has been increasing evidence that some antihypertensive drugs like clonidine and alpha-methyldopa (after conversion in the brain to alpha-methylnorepinephrine) may decrease sympathetic tone by stimulating central nervous system (CNS) alpha 2-adrenoceptors. These same drugs also produce pupillary dilation in cats and rats. In this review, evidence is presented supporting the hypothesis that clonidinelike drugs act either directly or indirectly on CNS postsynaptic alpha 2-adrenoceptors to cause pupillary dilation by reduction of parasympathetic neural tone to the iris. It is further suggested that the underlying physiologic mechanism for this mydriatic action is activation of an ascending pathway that provides tonic inhibitory input by releasing norepinephrine on neurons in the Edinger-Westphal complex. Yohimbine-sensitive pupillary dilation in these species may provide a simple and effective model for quantitatively accessing CNS alpha 2-adrenoceptor activity.