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Western Australia Atropine for the Treatment of Myopia (WA-ATOM) study: Rationale, methodology and participant
Samantha S Y Lee1, David A Mackey1,2,3, Gareth Lingham1
1Centre for Ophthalmology and Visual Sciences (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.
Insights
Low-dose atropine eyedrops show promise for controlling myopia in Australian children. The WA-ATOM study investigates its efficacy and long-term effects in diverse populations.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Low-dose atropine eyedrops are recognized for their potential in slowing myopia progression, particularly in East Asian children.
- However, their effectiveness and safety in Australian children, including those of non-Asian descent, remain under-researched.
Purpose of the Study:
- To evaluate the efficacy and long-term effects of low-dose atropine (0.01%) eyedrops for myopia control in Australian children.
- To assess the tolerability and safety profile of this treatment in a pediatric population.
- To explore factors influencing treatment efficacy, such as ocular sun exposure, iris color, and parental myopia.
Main Methods:
- A single-center, double-masked, randomized controlled trial (Western Australia Atropine for the Treatment of Myopia - WA-ATOM study).
- 153 children aged 6-16 years with myopia were randomized (2:1) to receive 0.01% atropine or placebo eyedrops.
- Participants underwent examinations every 6 months for 3 years (including a 1-year washout), with a 5-year follow-up planned.
Main Results:
- The study enrolled 153 children out of 242 eligible participants from an initial referral pool of 311.
- Baseline characteristics of the enrolled participants are detailed in the study.
- The primary outcome measures include the annual progression rate of myopia and axial length, alongside tolerability and adverse event incidence.
Conclusions:
- The WA-ATOM study will provide crucial data on the efficacy, tolerability, and safety of low-dose atropine for myopia control in Australian children.
- Findings will inform clinical practice and guide future research on myopia management in diverse pediatric populations.
- The study will also investigate the influence of environmental and genetic factors on treatment outcomes.
Importance:
Atropine eyedrops are a promising treatment for slowing myopia progression in East Asian children. However, its effects on children in Australia, including those of non-Asian background, have not been well-studied.
Background:
The Western Australia Atropine for the Treatment of Myopia (WA-ATOM) study aims to determine the efficacy and long-term effects of low-dose atropine eyedrops in myopia control. This paper describes the study rationale, methodology and participant baseline characteristics.
Design:
Single-centre, double-masked, randomized controlled trial.
Participants:
Children (6-16 years) with spherical equivalent ≤-1.50 D in each eye, astigmatism ≤1.50 D and myopia progression by ≥0.50 D/year.
Methods:
Enrolled children were randomly assigned 2:1 to receive 0.01% atropine or placebo eyedrops. Participants are examined every 6 months during first 3 years of the study (2-year treatment phase followed by a 1-year washout phase), and then at a 5-year follow-up (2 years after the end of the washout phase).
Main Outcome Measures:
Annual progression rate of myopia and axial length, tolerability to eyedrops and incidence and severity of unwanted effects.
Results:
Out of 311 children who were referred, 242 were suitable for study participation, and 153 were subsequently enrolled. The baseline characteristics of enrolled participants are presented.
Conclusions And Relevance:
Outcomes of the WA-ATOM study will inform on the efficacy, tolerability, safety and long-term effects of low-dose atropine eyedrops in myopia control in Australian children. The impact of ocular sun exposure, iris colour and parental myopia on the efficacy of low-dose atropine will also be assessed.
