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The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis
  1. F Koc1,
  2. S Kavuncu1,
  3. T Kansu2,
  4. G Acaroglu1,
  5. E Firat1
  1. 1SB Ulucanlar Eye Hospital, Neuro-ophthalmology Unit, Ankara, Turkey
  2. 2Hacettepe University Faculty of Medicine, Department of Neurology, Neuro-ophthalmology Unit, Ankara, Turkey
  1. Correspondence to: Dr Feray Koc Kuzgun sok 48/3 Asagi Ayranci, Ankara 06540, Turkey; dr_ferayyahoo.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.

  • HS, Horner syndrome
  • OSP, oculosympathetic paresis
  • oculosympathetic paresis
  • apraclonidine
  • Horner syndrome
  • HS, Horner syndrome
  • OSP, oculosympathetic paresis
  • oculosympathetic paresis
  • apraclonidine
  • Horner syndrome
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Footnotes

  • Competing interests: none declared

  • This study was conducted in Hacettepe University Hospitals and SB Ulucanlar Eye Hospital, under the approval of our institutional ethic committee.

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