Effect of low-dose atropine on myopia progression, pupil diameter and accommodative amplitude: low-dose atropine and myopia progression

Abstract

PurposeTo evaluate the effects of 0.01% and 0.02% atropine eye drops on myopia progression, pupil diameter and accommodative amplitude in myopic children.MethodsA cohort study assessed 400 myopic children divided into three groups: 138 and 142 children were randomised to use either 0.02% or 0.01% atropine eye drops, respectively. They wore single-vision (SV) spectacles, with one drop of atropine eye drop applied to both eyes once nightly. Control children (n=120) only wore SV spectacles. Repeated measurements of spherical equivalent refractive errors (SERs), axial length (AL), pupil diameter and accommodative amplitude were performed at baseline, and 4, 8 and 12 months after treatment.ResultsAfter 12 months, the SER change was −0.38±0.35D, −0.47±0.45D, −0.70±0.60D and AL change was 0.30±0.21 mm, 0.37±0.22 mm, 0.46±0.35 mm in the 0.02%, 0.01% atropine and control groups, respectively. There were significant differences in the change in AL and SER between three groups (all p<0.001). Between baseline and the 12-month visit, the overall change in accommodative amplitude was 1.50±0.25D, 1.61±0.31D and change in pupil diameter was 0.78±0.42 mm, 0.69±0.39 mm, with 0.02% and 0.01% atropine, respectively. Accommodative amplitude significantly decreased and pupil diameter significantly increased in two atropine groups (all p<0.001). Moreover, there was no statistical difference in the change difference in accommodative amplitude and pupil diameter between two atropine groups (p=0.24, p=0.38), whereas the accommodative amplitude (p=0.45) and pupil diameter (p=0.39) in the control group remained stable.Conclusions0.02% atropine eye drops had a better effect on myopia progression than 0.01% atropine, but 0.02% and 0.01% atropine showed similar effects on pupil diameter and accommodative amplitude after 12 months of treatment.Trial registration numberChiCTR-IPD-16008844.

The Combined Effect of Low-dose Atropine with Orthokeratology in Pediatric Myopia Control: Review of the Current Treatment Status for Myopia

“…In a 0.01% atropine concentration study, Wu et al [58] found that only 7% of the participants presented photophobia. Pupil dilation, accommodation amplitude (0.05% eyes (13.24 ± 2.72 D)), and near vision loss [30] were minimal with 0.01% atropine, but they were significant compared to patients who did not have this treatment [35]. This impact returned to untreated levels two months after treatment interruption [59].…”

Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents

“…People who are myopic have impaired ability to see objects clear at distance, thereby potentially affecting their academic and job performance as well as career choices. Although clinical interventions that can effectively slow myopia progression, such as low dose atropine [18] and orthokeratology [19] are currently available, myopia progression intervention measures should also be implemented through early detection and early childhood education.…”

The Effect of 0.01% Atropine Eye Drops Combined with Auricular Acupoint Stimulation on Myopia Progression and Choroidal Thickness: The Preliminary Results from a Randomized Controlled Trial

“…In recent years, administration of 0.01% atropine eye drops (0.01%A) has become one of the most common treatment modalities for myopia control for children in Asia [15]. Compared with blank control and placebo control, 0.01%A could slow myopia progression by roughly 0.25 D in one year [16,17]. In contrast, the effect of 0.01%A on axial length (AL) elongation remains controversial [17,18].…”