Oculocardiac Reflex During ROP Exams

August C Schumacher,1 Michelle L Ball,2 Andrew W Arnold,3 Robin L Grendahl,4 R Kevin Winkle,4 Robert W Arnold5 1US Ski Team, Alaska Winter Stars, Anchorage, AK, USA; 2Pediatric Department, Alaska Native Medical Center, Anchorage, AK, USA; 3College of Osteopathic Medicine, Pacific Northwest Universit...

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Autores principales:	Schumacher AC, Ball ML, Arnold AW, Grendahl RL, Winkle RK, Arnold RW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	bradycardia retinopathy of prematurity strabismus Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9ea8847a6d74480ba78ecf0fc6f7a3af
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spelling	oai:doaj.org-article:9ea8847a6d74480ba78ecf0fc6f7a3af2021-12-02T15:16:30ZOculocardiac Reflex During ROP Exams1177-5483https://doaj.org/article/9ea8847a6d74480ba78ecf0fc6f7a3af2020-12-01T00:00:00Zhttps://www.dovepress.com/oculocardiac-reflex-during-rop-exams-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483August C Schumacher,1 Michelle L Ball,2 Andrew W Arnold,3 Robin L Grendahl,4 R Kevin Winkle,4 Robert W Arnold5 1US Ski Team, Alaska Winter Stars, Anchorage, AK, USA; 2Pediatric Department, Alaska Native Medical Center, Anchorage, AK, USA; 3College of Osteopathic Medicine, Pacific Northwest Universit, Yakima, WA, USA; 4Alaska Children’s EYE & Strabismus, Anchorage, AK, USA; 5Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USACorrespondence: Robert W ArnoldAlaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche #280, Anchorage, AK 99508, 99508 Tel +1 907 561-1917Fax +1 907 563-5373Email eyedoc@alaska.netPurpose: Reducing physiologic stress including bradycardia during staging eye exams for retinopathy of prematurity (ROP) is desirable. We observed heart rate change during routine retinopathy of prematurity eye examinations and compared the response with our ongoing study of oculocardiac reflex (OCR) elicited by uniform EOM tension during strabismus surgery.Patients and Methods: Electrocardiograph was prospectively monitored during ROP exams featuring indirect ophthalmoscopy with Alfonso lid speculum and see-through scleral depressor without topical anesthesia. Clinical data were retrieved from ROP-Check software. OCR was defined as maximally changed heart rate (HR) as a percent of baseline. Strabismus surgery patients under general anesthesia served as controls.Results: From 10/2017 to 9/2020, 281 infants had ROP exams, and the median OCR was 55.9% of baseline HR (IQR 41.4% to 72.6%), the kurtosis 0.93 and skewness 1.01 representing a drop from HR 169 ± 16 bpm to 102 ± 39 bpm. In comparison, 1493 adult and pediatric strabismus surgery patients had less OCR median bradycardia 87.8% (IQR 72– 98%), kurtosis 1.60 and skewness − 1.18. ROP %OCR correlated with birth gestational age (%OCR = 2.5 (GA) – 11, r(279)=0.33, p< 0.01) and with birthweight (%OCR = 0.02 (BW) + 38, r(279) =0.35, p< 0.01). The duration of bradycardia induced by ROP exam averaged 92 ± 34 seconds (range 34– 240 seconds).Conclusion: Bradycardia is common during eye exams in the smallest premature infants with greater degree, more rapid onset and longer duration than OCR during strabismus surgery.Keywords: bradycardia, retinopathy of prematurity, strabismusSchumacher ACBall MLArnold AWGrendahl RLWinkle RKArnold RWDove Medical Pressarticlebradycardiaretinopathy of prematuritystrabismusOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4263-4269 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	bradycardia retinopathy of prematurity strabismus Ophthalmology RE1-994
spellingShingle	bradycardia retinopathy of prematurity strabismus Ophthalmology RE1-994 Schumacher AC Ball ML Arnold AW Grendahl RL Winkle RK Arnold RW Oculocardiac Reflex During ROP Exams
description	August C Schumacher,1 Michelle L Ball,2 Andrew W Arnold,3 Robin L Grendahl,4 R Kevin Winkle,4 Robert W Arnold5 1US Ski Team, Alaska Winter Stars, Anchorage, AK, USA; 2Pediatric Department, Alaska Native Medical Center, Anchorage, AK, USA; 3College of Osteopathic Medicine, Pacific Northwest Universit, Yakima, WA, USA; 4Alaska Children’s EYE & Strabismus, Anchorage, AK, USA; 5Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USACorrespondence: Robert W ArnoldAlaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche #280, Anchorage, AK 99508, 99508 Tel +1 907 561-1917Fax +1 907 563-5373Email eyedoc@alaska.netPurpose: Reducing physiologic stress including bradycardia during staging eye exams for retinopathy of prematurity (ROP) is desirable. We observed heart rate change during routine retinopathy of prematurity eye examinations and compared the response with our ongoing study of oculocardiac reflex (OCR) elicited by uniform EOM tension during strabismus surgery.Patients and Methods: Electrocardiograph was prospectively monitored during ROP exams featuring indirect ophthalmoscopy with Alfonso lid speculum and see-through scleral depressor without topical anesthesia. Clinical data were retrieved from ROP-Check software. OCR was defined as maximally changed heart rate (HR) as a percent of baseline. Strabismus surgery patients under general anesthesia served as controls.Results: From 10/2017 to 9/2020, 281 infants had ROP exams, and the median OCR was 55.9% of baseline HR (IQR 41.4% to 72.6%), the kurtosis 0.93 and skewness 1.01 representing a drop from HR 169 ± 16 bpm to 102 ± 39 bpm. In comparison, 1493 adult and pediatric strabismus surgery patients had less OCR median bradycardia 87.8% (IQR 72– 98%), kurtosis 1.60 and skewness − 1.18. ROP %OCR correlated with birth gestational age (%OCR = 2.5 (GA) – 11, r(279)=0.33, p< 0.01) and with birthweight (%OCR = 0.02 (BW) + 38, r(279) =0.35, p< 0.01). The duration of bradycardia induced by ROP exam averaged 92 ± 34 seconds (range 34– 240 seconds).Conclusion: Bradycardia is common during eye exams in the smallest premature infants with greater degree, more rapid onset and longer duration than OCR during strabismus surgery.Keywords: bradycardia, retinopathy of prematurity, strabismus
format	article
author	Schumacher AC Ball ML Arnold AW Grendahl RL Winkle RK Arnold RW
author_facet	Schumacher AC Ball ML Arnold AW Grendahl RL Winkle RK Arnold RW
author_sort	Schumacher AC
title	Oculocardiac Reflex During ROP Exams
title_short	Oculocardiac Reflex During ROP Exams
title_full	Oculocardiac Reflex During ROP Exams
title_fullStr	Oculocardiac Reflex During ROP Exams
title_full_unstemmed	Oculocardiac Reflex During ROP Exams
title_sort	oculocardiac reflex during rop exams
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/9ea8847a6d74480ba78ecf0fc6f7a3af
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Oculocardiac Reflex During ROP Exams

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