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Choroidal Changes During and After Discontinuing Long-Term 0.01% Atropine Treatment for Myopia Control.

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Area of Science:

  • Ophthalmology
  • Pediatric ophthalmology
  • Myopia control research

Background:

  • Myopia control strategies are crucial for preventing vision impairment.
  • Long-term effects of myopia control interventions on ocular structures require further investigation.
  • Choroidal changes are associated with refractive development and myopia progression.

Purpose of the Study:

  • To evaluate choroidal thickness (ChT) and choroidal vascularity index (CVI) during and after discontinuing low-concentration atropine eye drops for myopia control.
  • To assess the impact of 0.01% atropine cessation on choroidal development in children.
  • To compare choroidal changes between atropine and placebo groups after treatment discontinuation.

Main Methods:

  • A 2-year randomized controlled trial involving 153 children (6-16 years) with progressive myopia, comparing 0.01% atropine to placebo.
  • A subsequent 1-year washout period with no eye drop use.
  • Optical coherence tomography (OCT) imaging to measure subfoveal choroidal thickness (ChT) and choroidal vascularity index (CVI) at baseline, end of treatment, and end of washout.

Main Results:

  • No significant difference in subfoveal choroidal thickening between atropine and placebo groups during the 2-year treatment phase.
  • During the 1-year washout, the placebo group showed continued choroidal thickening, while the atropine group's choroid thickness remained stable.
  • Choroidal thickening correlated with axial eye growth control; however, in fast-progressing children, atropine's effect on choroidal thickening was not sustained after cessation.
  • Choroidal vascularity index decreased during treatment but increased in the placebo group post-cessation.

Conclusions:

  • While 0.01% atropine did not differentially affect choroidal thickness during treatment compared to placebo, its abrupt cessation may interfere with normal choroidal development in children.
  • Discontinuing long-term low-concentration atropine may lead to altered choroidal adaptation.
  • Further research is needed to understand the long-term implications of atropine cessation on ocular development and refractive error progression.