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Aims: To evaluate the sensitivity and specificity of 0.5%apraclonidinetest in the diagnosis of oculosympathetic paresis(OSP). Method: Apraclonidine (0.5%) was administered to31 eyes, nine with a diagnosis of Horner syndrome (HS), 22with bilateral OSP caused by diabetes, and to 54 control eyes.All were confirmed with the cocaine test. The effects on pupildiameter and upper eyelid level were observed 1 hour later. Results:Apraclonidine caused a mean dilation of 2.04 mm (range1-4.5) (p< 0.001) in the pupils with OSP and it caused pupillaryconstriction in the control eyes with a mean change of -0.14mm (range 0.5 to -1) (p< 0.05). It caused reversal of anisocoriain all HS cases. Its effects on both pupil diameters and upper lidlevels differed significantly between the groups (p< 0.001). Themean elevation in the upper lid was 1.75 mm (range 1-4) in theOSP group (p< 0.001) and 0.61 mm (range 0-3) in the controlgroup (p< 0.001). Conclusion: The effect of the apraclonidine(0.5%) test on the pupil diameter was diagnostic for OSP andhad at least the same sensitivity and specificity as the cocainetest for the diagnosis of OSP.
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 The effects on pupildiameter and upper eyelid level were observed 1 hour later. Results: Apraclonidine caused a mean dilation of 2.04 mm (range1-4.5) (p <0.001) in the pupils with OSP and it caused pupillaryconstriction in the control eyes with a mean change of -0.14 mm (range 0.5 to -1) (p <0.05). It caused reversal of anisocoriain all HS cases. Its effects on both pupil diameters and Themean 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) <0.001). Conclusion: The effect of the apraclonidine (0.5%) test on the pup il diameter was diagnostic for OSP andhad at least the same sensitivity and specificity as the cocainetest for the diagnosis of OSP.