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Myopia Progression Study Comparing Low-Dose (0.01%) Atropine Eye Drops with a Control Group
Hortensia Sanchez-Tocino1, Ana Villanueva Gomez1, Rebeca Saldaña Burgos1
1Department of Ophthalmology, Hospital Universitario Rio Hortega, Valladolid, Spain.
Insights
Low-dose atropine eye drops (0.01%) did not significantly slow myopia progression in children. Younger children (<9 years) showed less treatment success, indicating a need for higher concentrations or combined therapies for effective myopia control.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research
Background:
- Myopia progression is a significant concern in children's eye health.
- Current treatments aim to slow the rate of refractive error increase and axial elongation.
- Understanding the efficacy of low-dose atropine is crucial for pediatric myopia management.
Purpose of the Study:
- To evaluate the effectiveness of 0.01% atropine eye drops in controlling myopia progression in children.
- To compare the progression rates of spherical equivalent refractive error (SER) and axial length (AL) between atropine-treated and control groups.
- To analyze treatment response based on age.
Main Methods:
- A longitudinal study comparing two cohorts of myopic children (atropine vs. control).
- Inclusion criteria: myopia increase > -0.50 D or AL growth > 0.20 mm in the prior year.
- Data collection included examinations every 6 months for 18 months, measuring SER and AL.
Main Results:
- No statistically significant difference in SER change (p=0.295) or AL increase (p=0.160) between atropine and control groups at 18 months.
- Children under 9 years old demonstrated the lowest success rate (27.8%) and highest failure rate (63.2%) with 0.01% atropine (p=0.03).
- The mean change in SER was -0.73 D for atropine vs. -0.85 D for control; mean AL increase was 0.33 mm for atropine vs. 0.41 mm for control.
Conclusions:
- 0.01% atropine eye drops were not effective in slowing myopia progression in the observed pediatric population.
- Higher concentrations or combination therapies may be required for myopia control.
- Younger children (<9 years) require specific consideration due to lower treatment efficacy and higher progression potential.
Abstract:
Purpose: To evaluate myopia progression in children treated with 0.01% atropine eye drops compared with controls. Methods: Two longitudinal cohorts of myopic children (atropine and control) were observed in different time periods. All children had an increase in myopia of greater than -0.50 diopters (D) or axial length (AL) growth of >0.20 mm in the previous year. Patients were examined at baseline and every 6 months for 18 months. The primary outcomes were the annual progression rate of spherical equivalent refractive error (SER) and AL. Response to treatment was categorized as insufficient, moderate, or good. Progression according to age was also evaluated. Statistical significance was defined as P < 0.05. Results: The study included 243 myopic children [127 (44.7%) female; mean age, 10.19 ± 2.29 years]. The atropine group comprised 158 (65%) children. At 18 months, the mean (95% confidence interval) change in SER was -0.85 D (-1.00, -0.69) in the control group and -0.73 D (-0.85, -0.61) in atropine (p = 0.295). The mean increase in AL was 0.41 mm (0.32, 0.50) in the control group and 0.33 mm (0.28, 0.39) in the atropine (p = 0.160). Children aged <9 years had the lowest percentage of success [3/21 (27.8%)] in the atropine group and the highest percentage of failure (63.2%) (p = 0.03). Conclusion: Atropine drops at 0.01% did not slow myopia progression. Increasing the concentration or combining with optical treatments may be necessary, particularly for children aged <9 years, who showed the greatest progression but also had the highest potential for myopia control.
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