Classification-Based Approaches to Myopia Control in a Taiwanese Cohort

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Clinical Research

Background:

• Childhood myopia is a global health concern, particularly prevalent in Asia, necessitating effective interventions.
• Low-dose atropine is a recognized treatment for slowing myopia progression, but optimal concentration remains debated.

Purpose of the Study:

• To establish an axial length growth curve for Taiwanese children.
• To investigate the efficacy of a risk-level-based, multi-concentration low-dose atropine approach for myopia control.

Main Methods:

• A two-stage study involving observational data collection and a subsequent 2-year interventional trial.
• Axial growth curves were plotted for 4,091 Taiwanese children (ages 3-16).
• 886 children were enrolled in the interventional stage, receiving 0.02%, 0.03%, or 0.05% low-dose atropine based on their myopia risk level.

Main Results:

• Myopia prevalence increased from 2.3% in 4-year-olds to 88.0% in 16-year-olds.
• Mean annual myopia progression was -0.33 D (low risk), -0.57 D (moderate risk), and -0.82 D (high risk).
• Responder rates (progression < -1.0 D/year) were 95.77% (low risk), 83.52% (moderate risk), and 70.59% (high risk).

Conclusions:

• A classification-based approach using individualized low-dose atropine concentrations effectively controls myopic progression.
• This strategy minimizes side effects by avoiding unnecessarily high atropine doses.
• Personalized myopia management based on risk assessment offers a promising therapeutic avenue.