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Risk factors for rapid axial length elongation with low concentration atropine for myopia control

Aicun Fu1, Fiona Stapleton2, Li Wei1

  • 1The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe road, Zhengzhou, 450000, China.

Scientific Reports
|June 4, 2021
PubMed

Insights

Younger children using lower concentration 0.01% atropine eye drops may experience rapid axial length elongation. This myopia progression is linked to shorter baseline axial length and smaller pupil diameter changes over 12 months.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Myopia Control

Background:

  • Myopia is a growing global health concern, particularly in children.
  • Effective myopia control strategies are crucial to prevent high myopia and associated ocular pathologies.
  • Low-dose atropine eye drops are a recognized treatment for slowing myopia progression.

Purpose of the Study:

  • To identify risk factors associated with rapid axial length (AL) elongation in myopic children undergoing atropine treatment.
  • To compare the effects of 0.01% and 0.02% atropine concentrations on myopia progression.
  • To analyze the relationship between baseline characteristics and AL changes over a 12-month period.

Main Methods:

  • A randomized study involving 328 myopic children using either 0.01% or 0.02% atropine.
  • Collection of baseline and 1-year data including age, BMI, refractive error (SER), anterior chamber depth (ACD), and axial length (AL).
  • Statistical analyses (univariate and multivariate logistic regression) to determine predictors of rapid AL elongation (>0.36 mm/year).

Main Results:

  • Rapid AL elongation was associated with younger age at baseline (P < 0.0001).
  • Use of 0.01% atropine was linked to increased risk of rapid AL elongation (P = 0.04).
  • Shorter baseline AL (P = 0.03) and smaller changes in pupil diameter (P = 0.04) were also significant predictors.

Conclusions:

  • Younger children with shorter baseline axial length are at higher risk for rapid AL elongation.
  • The lower concentration of 0.01% atropine may be less effective in preventing rapid axial length growth compared to higher concentrations.
  • Smaller changes in pupil diameter during treatment may indicate a higher risk of myopia progression.

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