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The optimal atropine concentration for myopia control in Chinese children: a systematic review and network
Xiao-Yan Wang1, Hong-Wei Deng2, Jian Yang3
1School of Nursing, Southwest Medical University, Luzhou 646600, Sichuan Province, China.
Insights
Low-dose atropine effectively slows myopia progression in Chinese youth. While 1% atropine shows the most significant refractive and axial length changes, 0.05% atropine is recommended due to fewer adverse effects.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Myopia Control
Background:
- Myopia is a growing public health concern in children and adolescents.
- Effective interventions are needed to slow myopia progression and prevent associated complications.
- Atropine eye drops are a recognized treatment for myopia control.
Purpose of the Study:
- To evaluate the efficacy of various atropine concentrations in slowing myopia progression in Chinese children and teenagers.
- To determine the optimal atropine concentration for myopia control in this population.
Main Methods:
- A systematic literature search was conducted across multiple databases up to January 17, 2024.
- Data from 14 studies involving 2475 participants were analyzed using network meta-analysis.
- The study compared five different atropine concentrations against a control group.
Main Results:
- All tested atropine concentrations demonstrated a reduction in myopia progression compared to the control.
- 1% atropine showed the highest efficacy in controlling both refractive error and axial length changes.
- The efficacy ranking was 1% > 0.05% > 0.025% > 0.02% > 0.01% atropine.
Conclusions:
- Various concentrations of atropine can effectively slow myopia progression in Chinese children and adolescents.
- Despite 1% atropine's superior efficacy, its high incidence of adverse effects is a concern.
- 0.05% atropine is suggested as the optimal concentration for balancing efficacy and safety in this demographic.
Aim:
To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia.
Methods:
A systematic search was conducted across the Cochrane Library, PubMed, Web of Science, EMBASE, CNKI, CBM, VIP, and Wanfang database, encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17, 2024. Data extraction and quality assessment were performed, and a network Meta-analysis was executed using Stata version 14.0 Software. Results were visually represented through graphs.
Results:
Fourteen papers comprising 2475 cases were included; five different concentrations of atropine solution were used. The network Meta-analysis, along with the surface under the cumulative ranking curve (SUCRA), showed that 1% atropine (100%)>0.05% atropine (74.9%) >0.025% atropine (51.6%)>0.02% atropine (47.9%)>0.01% atropine (25.6%)>control in refraction change and 1% atropine (98.7%)>0.05% atropine (70.4%)>0.02% atropine (61.4%)>0.025% atropine (42%)>0.01% atropine (27.4%)>control in axial length (AL) change.
Conclusion:
In Chinese children and teenagers, the five various concentrations of atropine can reduce the progression of myopia. Although the network Meta-analysis showed that 1% atropine is the best one for controlling refraction and AL change, there is a high incidence of adverse effects with the use of 1% atropine. Therefore, we suggest that 0.05% atropine is optimal for Chinese children to slow myopia progression.
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