Effect of 0.01% Atropine on Choroidal Thickness and Ocular Growth in Pre-myopic Children
Meinan He1, Luqiang Wang1, Shuwei Zhang1
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Insights
Nightly low-dose atropine eye drops showed a trend toward reduced choroidal thinning in pre-myopic children, but differences were not statistically significant. Choroidal thickness changes may associate with ocular growth.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Myopia Research
Background:
- Myopia is a growing public health concern in children.
- Choroidal thickness (ChT) is a potential indicator of ocular growth and myopia progression.
- Low-dose atropine is used to slow myopia progression, but its effect on choroidal thickness needs further investigation.
Purpose of the Study:
- To evaluate the impact of nightly 0.01% atropine eye drops on choroidal thickness (ChT) in pre-myopic children.
- To analyze changes in macular ChT over 12 months in children at risk of myopia.
Main Methods:
- A 12-month randomized, double-blind, placebo-controlled trial involving 54 children aged 5-12.
- Nightly administration of 0.01% atropine or placebo in both eyes.
- Swept-source OCT used for ChT measurements in 15 macular sectors; longitudinal mixed-effects models and clustering analysis employed.
Main Results:
- Both atropine and placebo groups exhibited progressive choroidal thinning over 12 months.
- A trend towards less choroidal thinning was observed in atropine-treated eyes, particularly in central, inferior, and temporal sectors, but did not reach statistical significance.
- Clustering revealed distinct 'Thinning-dominant' and 'Stable ChT' patterns, with the 'Thinning-dominant' group showing faster axial elongation.
Conclusions:
- Nightly low-dose atropine demonstrated a non-significant trend in reducing macular choroidal thinning in pre-myopic children.
- Choroidal thickness response heterogeneity was observed, with exploratory associations between thinning patterns and ocular growth.
- Further validation is needed; early ChT changes are not yet a clinically actionable treatment-response marker.
Purpose:
To investigate the effect of nightly 0.01% atropine eye drops on choroidal thickness (ChT) in pre-myopic children (at risk of myopia).
Methods:
In a 12-month randomised, double-blind, placebo-controlled trial, 54 children aged 5-12 received nightly 0.01% atropine or placebo in both eyes. ChT was measured in 15 macular sectors using swept-source OCT at baseline and every 3 months. Longitudinal mixed-effects models (LMM) compared ChT changes between groups, and an unsupervised clustering analysis of individual ChT trajectories was performed.
Results:
Both groups showed progressive choroidal thinning. At 12 months, atropine-treated eyes showed a trend towards less choroidal thinning than placebo, especially in the central, inferior and temporal macular areas, but between-group differences did not reach statistical significance after multiple comparison correction. Clustering of ChT trajectories revealed two exploratory clusters: a "Thinning-dominant" pattern with pronounced mid-year thinning (6-9 months) followed by partial recovery by month 12 and a "Stable ChT" pattern with minimal change. Eyes in the Thinning-dominant group had faster axial elongation than the Stable group, suggesting an association between ΔChT clusters and ocular growth.
Conclusions:
Nightly low-dose atropine in pre-myopic children showed a non-significant trend toward reduced macular choroidal thinning. Clustering and early-change analyses revealed heterogeneity in ChT responses and exploratory associations with ocular growth. These findings require external validation and do not support early ΔChT as a clinically actionable treatment-response marker.
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