Atropine (0.05%) for rapid progressive childhood myopia (ARM study)
Rohit Saxena1, Vinay Gupta, Himani Thakur
1Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Insights
Low-dose atropine eye drops effectively reduced myopia progression in children with rapid worsening vision. This myopia control treatment showed a 62% reduction in progression and no adverse effects over one year.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Clinical Research
Background:
- Myopia, or nearsightedness, is a growing global health concern, particularly in children.
- Rapid myopia progression in childhood can increase the risk of serious eye conditions later in life.
- Effective myopia control strategies are crucial for preserving long-term visual health.
Purpose of the Study:
- To evaluate the efficacy of low-dose atropine 0.05% in controlling rapid myopia progression in children.
- To assess changes in refractive error and axial length over a one-year treatment period.
- To document any adverse effects associated with atropine 0.05% use.
Main Methods:
- A prospective, single-arm clinical trial was conducted involving children aged 6-12 years with myopia progression exceeding 0.75D per year.
- Participants received atropine 0.05% eye drops nightly for one year.
- Primary outcomes included changes in the rate of myopia progression (diopters/year), spherical equivalent refractive error (SER), and axial length (AL).
Main Results:
- Treatment with atropine 0.05% resulted in a significant 62% reduction in the rate of myopia progression (P < 0.001).
- The mean progression rate decreased from -1.05 D/year at baseline to -0.4 D/year after one year.
- No significant adverse effects were reported, and treatment response was independent of baseline characteristics.
Conclusions:
- Atropine 0.05% is a safe and effective treatment for managing rapidly progressing myopia in children.
- This low-dose atropine therapy offers a promising option for myopia control with a favorable side effect profile.
- Further research may explore long-term outcomes and optimal dosing strategies.
Purpose:
This study aims to assess the effectiveness of atropine 0.05% for myopia control among children exhibiting (documented) rapid myopia progression (>0.75D/year).
Methods:
This prospective interventional single-arm clinical trial included children aged between 6-12 years, spherical equivalent refractive (SER) error between - 2 and - 6D, and having documented myopia progression of >0.75D in the preceding year. All participants were administered atropine 0.05% in both eyes once at bedtime for 1 year. The primary outcome measure was a change in the rate of myopia progression (D/year) and change in SER and axial length (AL) at 1 year and documentation of any adverse effects related to therapy.
Results:
Forty children were enrolled with a mean age of 8.5 ± 2.2 years. (45% male) The mean SER 1 year before starting atropine treatment was -3.53 ± 0.78D. At baseline, the mean SER was -4.58 ± 1.03D, which increased to -4.98 ± 0.97D after 1-year follow-up. The study reported a 62% reduction in the rate of myopia progression after 1 year of atropine 0.05% treatment (-1.05 ± 0.21D/year [baseline] to - 0.4 ± 0.14D/year[1-year follow-up] [ P < 0.001]). The mean AL increased from 24.98 ± 2.43 mm (baseline) to 25.21 ± 2.32 mm (1 year). There was no significant correlation between changes in AL and SER ( r : 0.57; P : 0.063). The study observed the response to treatment was independent of the age at baseline, baseline refractive error, baseline rate of progression, gender, and family history of myopia. No adverse effects from atropine 0.05% were reported.
Conclusions:
Atropine 0.05% could be an effective treatment for children with rapidly progressing myopia with no significant side effects.
Related Concept Videos
01:11Direct-Acting Cholinergic Agonists: Therapeutic Uses
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
00:59Direct-Acting Cholinergic Agonists: Pharmacological Actions
01:30Indirect-Acting Cholinergic Agonists: Pharmacological Actions
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
01:29Cholinergic Antagonists: Chemistry and Structure-Activity Relationship
01:28Angle Closure Glaucoma: Treatment