Evaluation Of Tropicamide-Induced Cycloplegia On Anterior Chamber Cells By Anterior Segment Oct

To evaluate the anterior chamber hyperreflective dot (HRD) density after cycloplegia with tropicamide using anterior segment optical coherence tomography (AS-OCT).

Department of Ophthalmology, Ege University Faculty of Medicine, Türkiye. Children aged 7 years or older who could cooperate were included. Exclusion criteria were prior eye surgery, chronic eye diseases, or any topical or systemic medication use.

Cycloplegia was induced with 1% tropicamide (two drops, 5 minutes apart). Laser flare photometry (FM-600; Kowa, Japan) and AS-OCT (Anterion; Heidelberg Engineering, Germany) were performed before and 30 minutes after the procedure. AS-OCT images were analysed in ImageJ (National Institutes of Health, Bethesda, USA). The anterior chamber area (ACA) was manually outlined (region of interest, ROI) for each scan. Artifacts were excluded with a separate ROI, and the ACA (pixels²) was calculated. HRDs were automatically detected and counted within the ACA. Density was reported as HRD per 10,000 pixels², calculated by dividing the number of HRDs by the ACA area. Results were compared with laser flare measurements.

A total of 52 eyes from 26 patients were included. The mean age was 10.46±2.2 (7-16), and the female/male ratio was 16/10. The mean HRD density pre-cycloplegia was 0.45±0.76 and increased to 0.81±1.06 post-cycloplegia (p = 0.048). The mean pre- and postcycloplegia flares were 0.479 ± 0.848 ph/ms and 0.982 ± 2.577, respectively (p=0.393). No correlation was found between pre- and post-cycloplegia HRD density and flare values (p = 0.708, ρ = 0.057, p = 0.954, ρ = 0.0088, respectively).

AS-OCT, which is gaining attention in many anterior segment pathologies, detected a small but significant increase in cells in children after cycloplegia with tropicamide, an increase that was undetectable by laser flare.