1. Effect of mannitol on globe and orbital volumes in humans
- Author
-
Alexander D Blandford, Julian D. Perry, Bryan R. Costin, and Adam C Weber
- Subjects
Adult ,Male ,Intraocular pressure ,Volume change ,Eye ,Computed tomographic ,Tonometry, Ocular ,03 medical and health sciences ,0302 clinical medicine ,Chart review ,Humans ,Medicine ,Mannitol ,Infusions, Intravenous ,Intraocular Pressure ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,Diuretics, Osmotic ,Volume measurements ,Ophthalmology ,Volume (thermodynamics) ,030221 ophthalmology & optometry ,Female ,sense organs ,Tomography, X-Ray Computed ,Nuclear medicine ,business ,Orbit ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose: To determine the effect of intravenous mannitol on globe and orbital volumes. Methods: Retrospective chart review of a consecutive series of Cleveland Clinic Neurosurgical Intensive Care Unit patients who underwent computed tomographic imaging before and after intravenous mannitol administration. Volume measurements were performed according to a previously described technique by averaging axial image areas. Measurements before and after mannitol administration were compared using paired t-test. Results: Fourteen patients (28 eyes) met inclusion criteria. Average globe volume decreased 186 mm3 (-2.5%, p = 0.02) after mannitol administration, while average orbital volume increased 353 mm3 (+3.5%, p = 0.04). Average globe volume change for subjects with follow-up scan less than 4.7 hours (mean 1.9 hours; range 0.2-4.5 hours) after mannitol administration was -125 mm3 (-1.7%, p = 0.24) and average orbital volume change was +458 mm3 (+5.1%, p = 0.11). Average globe volume change after mannitol administration for those with follow-up more than 4.7 hours (average 13.9 hours, range 4.9-24.7 hours) was -246 mm3 (-3.3%, p = 0.05) and orbital volume change was +248 mm3 (+2.2%, p = 0.24). Dividing the study population into groups based on mannitol dose did not yield any statistically significant change. Conclusions: Human globe volume decreases after intravenous mannitol administration, while orbital volume increases. These volume changes occur during the time period when intraocular pressure normalizes, after the pressure-lowering effects of the drug. This novel volumetric information improves our understanding of mannitol’s mechanism of action and its effects on human ocular and periocular tissues.
- Published
- 2018
- Full Text
- View/download PDF