Effect of atropine 0.01% on myopia control in children aged 6–13 years during the 2022 lockdown in Shanghai

Abstract

PurposeTo compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai.MethodsIn this retrospective study, children aged 6–13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS).ResultsIn total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all p > 0.1). After the home confinement, a greater myopia progression was observed in the control group (−0.46 ± 0.42 D) compared to atropine group (−0.26 ± 0.37 D; p = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, p = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, p = 0.7261 and 0.08 ± 0.27 D for SE, p = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (−0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both p < 0.001).ConclusionChildren treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.

Myopia progression after cessation of atropine in children: a systematic review and meta-analysis

“…Of the 13 studies, two studies ( Erdinest et al, 2022b ; Erdinest et al, 2023 ) explored combination therapy with atropine. The 8 RCTs ( Tong et al, 2009 ; Chia et al, 2016 ; Zhu et al, 2020 ; Yam et al, 2022a ; Ye et al, 2022 ; Hieda et al, 2023 ; Medghal et al, 2023 ; Wei et al, 2023 ) and 5 non-RCTs ( Lin et al, 2013 ; Polling et al, 2020 ; Erdinest et al, 2022b ; Erdinest et al, 2023 ; Yu et al, 2023 ) included 2,060 children under 18 years old, and 9 of the studies were conducted in Asian countries, including Singapore and China. The average age of participants was 10.3 years old.…”

The optimal atropine concentration for myopia control in Chinese children: a systematic review and network Meta-analysis

“…The follow-up time reported for participants was between 5 and 24mo. The specific characteristics are presented in Table 1 [19][20][21][22][23][24][25][26][27][28][29][30][31][32] . Risk of Bias Eight studies mentioned the use of a table of random numbers to generate a randomized sequence, 8 studies mentioned the use of blinding of researchers during intervention implementation and outcome measurement, 10 studies described in detail the rate and reason behind loss of sample, and 14 studies had essentially balanced baseline information between the experimental and observation groups before intervention.…”

“…The Optimal Atropine Concentration in Terms of Efficacy and Safety A total of 14 articles [19][20][21][22][23][24][25][26][27][28][29][30][31][32] , of which 11 were RCTs, and three were retrospective cohort studies, were included to assess the efficacy of 1%, 0.05%, 0.025%, 0.02%, and 0.01% atropine for the treatment of Chinese children and adolescents using network Meta-analysis as an evaluation tool to select the optimal concentration for clinical provision. The results of this study showed that five different concentrations of atropine solution were superior to the control group in terms of efficacy.…”