Optic Nerve Head Changes over 15 Years-From the Atropine Treatment Long-Term Assessment Study

Area of Science:

• Ophthalmology
• Optometry
• Retinal Imaging

Background:

• The Atropine Treatment Long-Term Assessment Study (ATLAS) followed 148 myopic participants from the Atropine for the Treatment of Myopia 2 (ATOM2) trial.
• Participants received varying concentrations of atropine eye drops during the ATOM2 study.

Purpose of the Study:

• To investigate longitudinal changes in the optic nerve head (ONH) from childhood to adulthood over 15 years.
• To identify factors associated with ONH alterations in myopic individuals.

Main Methods:

• A longitudinal study design tracking participants over 15 years.
• Utilized cycloplegic autorefractometry, biometry, fundus photography, and optical coherence tomography (OCT) for ONH analysis.
• Morphometric examination of fundus photographs and OCT images assessed parameters like parapapillary atrophy (PPA) and Bruch membrane opening distance.

Main Results:

• Myopic refractive error increased significantly from baseline (-4.54 D) to 15 years (-6.88 D), with axial length also increasing.
• Significant ONH changes observed over 15 years included increased PPA and a nasal shift in the central retinal vascular trunk (CRVT) position.
• Age, axial length, and spherical equivalent refraction were confirmed as significant factors associated with optic disc changes.

Conclusions:

• Myopic individuals exhibit progressive ONH changes, specifically increased PPA and nasal CRVT shift, from childhood to young adulthood.
• These findings highlight the dynamic nature of the ONH in myopia progression over a 15-year period.