October 1, 2024
By Diba Rezazadeh, OD, AdvCertChVis(ACO)
Photo Credit: Dreamstime Photos
Topical low-dose atropine has become a popular myopia control treatment, and its ability to slow myopic progression has been widely studied. While the exact mechanism of how low-dose atropine slows myopic progression remains unknown, current theories suggest it is either via increasing dopamine release in the retina or by directly affecting scleral fibroblast activity.
Atropine is dose-dependent in terms of efficacy, side effects, and rebound. Daily 0.05% atropine has been recommended as an optimal balance of these factors. However, most studies leading to this recommendation have been in East Asian populations, and there has been uncertainty regarding extrapolating to other ethnicities.
This prospective, randomized longitudinal study of 361 children of European ancestry in Spain measured the efficacy of nightly 0.01% atropine in controlling myopia progression over a five-year period. Compared to the control group, the treatment group had less progression in spherical equivalent refractive error and axial length over the five-year period.
As expected, there was no effect on anterior chamber depth or keratometry. This study highlights that it may be worthwhile considering a patient’s ethnic background when deciding the concentration of low-dose atropine used in myopia control.
Abstract
Five-Year Results of Atropine 0.01% Efficacy in Myopia Control in a European Population
Manuel Moriche-Carretero, Remedios Revilla-Amores, Ana Gutiérrez-Blanco, Francisco Javier Moreno-Morillo, Clara Martinez-Perez, Miguel Ángel Sánchez-Tena, Cristina Alvarez-Peregrina
Aims: To evaluate the efficacy and safety of 0.01% atropine eye drops in controlling myopia progression over 5 years.
Methods: Experimental, analytical, prospective, randomized, and longitudinal study in 361 right eyes from 361 children randomized into the control group (177 eyes without treatment) and treatment group (184 eyes with 0.01% atropine eye drops). Children assigned to the treatment group used 0.01% atropine once a day every night, and the control group’s children did not use any treatment or placebo. All the subjects completed an eye examination every 6 months for the 5 years of follow-up. The examination included subjective and objective refraction with cycloplegia, axial length (AL), keratometry, and anterior chamber depth (ACD) to evaluate the efficacy of the treatment. It also included the anterior and posterior pole examination to evaluate the safety of the treatment.
Results: The SE increased −0.63±0.42D in children after 5 years of treatment with 0.01% atropine, while in the control group, the increase was −0.92±0.56D. AL increased 0.26±0.28 mm in the treatment group compared with 0.49±0.34 mm in the control group. Atropine 0.01% showed an efficacy of 31.5% and 46.9% in the control of the SE and AL increase, respectively. ACD and keratometry did not have significant changes between groups.
Conclusions: Atropine 0.01% is effective in slowing myopia progression in a European population. There were no side effects after 5 years of 0.01% atropine.
Moriche-Carretero, M., Revilla-Amores, R., Gutiérrez-Blanco, A., Moreno-Morillo, F. J., Martinez-Perez, C., Sánchez-Tena, M. Á., & Alvarez-Peregrina, C. (2024). Five-year results of atropine 0.01% efficacy in the myopia control in a European population. British Journal of Ophthalmology, 108(5), 715-719.
DOI: https://doi.org/10.1136/bjo-2022-322808
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Diba Rezazadeh graduated Doctor of Optometry from the University of Melbourne in 2022. She began working at the Australian College of Optometry (ACO) in 2023 as a Paediatric Resident and completed the ACO Advanced Certificate in Children’s Vision in 2023. She is heavily involved in the ACO’s children’s clinic, myopia clinic, and developmental & binocular vision clinic. |
