Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients

Sacchi, Matteo; Serafino, Massimiliano; Villani, Edoardo; Tagliabue, Elena; Luccarelli, Saverio; Bonsignore, Francesco; Nucci, Paolo

doi:10.1111/aos.14166

Cited by 61 publications

(60 citation statements)

References 31 publications

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“…Our study recorded a -0.55D progression of myopia after atropine 0.01% treatment for 1 year, which is similar to the -0.54D progression reported by Sacchi et al in 2019 ( Sacchi et al, 2019 ), the -0.64D progression reported in the LAMP study ( Yam et al, 2019b ), and the -0.43D progression reported in the ATOM2 study ( Chia et al, 2012 ). In the present study, the mean changes in axial length at 1 year from baseline was 0.43 ± 0.52 mm.…”

Section: Discussionsupporting

confidence: 90%

Analysis of Factors That May Affect the Effect of Atropine 0.01% on Myopia Control

et al. 2020

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Children respond differently to atropine treatment, and predicting patient factors associated with better myopia control is important. Therefore, we aimed to evaluate factors related to myopia progression in Chinese children treated with atropine 0.01%. This retrospective study included 133 children who were administered atropine 0.01% eyedrops every night for 1 year. Enrolled children were examined at follow-up visits at 3 and 6 months, and 1 year. The primary outcome was clinically significant myopia progression (over a-0.75 diopter (D) increase in spherical equivalent (SE)). Multivariate logistic analysis was used to identify predictive factors for myopia progression. The mean baseline SE was-3.92 ± 2.76D, and the average increase in SE and axial length at 1 year from baseline were-0.55 ± 0.57D and 0.43 ± 0.52 mm, respectively. The risk of myopia progression significantly increased in children whose mothers had moderate myopia of less than-6D compared to that in children whose mothers had no history of myopia (odd ratio [OR] = 2.76, 95% confidence interval [CI]: 1.06 to 7.19, P = 0.0382). Birth by cesarean section was also a risk factor for myopia progression (odd ratio [OR] = 2.35, 95% CI: 1.30 to 4.27, P = 0.0048). The correlation between SE and treatment efficiency was linear, and the risk of myopia progression significantly decreased with increasing SE. Atropine 0.01% controlled myopia more effectively in children with higher myopia, who were delivered naturally, and whose mothers had no genetic background of myopia.

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Section: Discussionsupporting

confidence: 90%

Analysis of Factors That May Affect the Effect of Atropine 0.01% on Myopia Control

et al. 2020

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“…However, not all children that observed pupil dilation also experienced photophobia. We observed a low rate of photophobia of 5.6%, comparable to Wei et al [32], and even slightly lower than what Sacchi et al [38] reported in their retrospective analysis. There was no need to prescribe photochromatic or multifocal glasses.…”

Section: Adverse Side Effectssupporting

confidence: 83%

A retrospective analysis of the therapeutic effects of 0.01% atropine on axial length growth in children in a real-life clinical setting

Kaymak

Graff

Schaeffel

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Background Several randomized controlled studies have demonstrated the beneficial effects of 0.01% atropine eye drops on myopia progression in children. However, treatment effects may be different in a routine clinical setting. We performed a retrospective analysis of our clinical data from children to investigate the effect of 0.01% atropine eye drops on myopia progression in a routine clinical setting. Methods Atropine-treated children were asked to instill one drop of 0.01% atropine in each eye every evening at 5 days a week. Myopic children who did not undergo atropine treatment served as controls. Objective refraction and ocular biometry of 80 atropine-treated and 103 untreated children at initial visit and 1 year later were retrospectively analyzed. Results Myopic refractions in the treated and untreated children at initial visit ranged from −0.625 to −15.25 D (−4.21 ± 2.90 D) and from −0.125 to −9.375 D (−2.92 ± 1.77 D), respectively. Ages at initial visit ranged from 3.2 to 15.5 years (10.1 ± 2.7 years) in the treated and from 3.4 to 15.5 years (11.2 ± 3.0 years) in untreated children. Two-factor ANOVA for age and atropine effects on axial length growth confirmed that axial length growth rates declined with age (p<0.0001) and revealed a significant inhibitory effect of atropine on axial length growth (p<0.0015). The atropine effect on axial length growth averaged to 0.08 mm (28%) inhibition per year. Effects on refraction were not statistically significant. Conclusion The observed atropine effects were not very distinctive: Statistical analysis confirmed that atropine reduced axial length growth, but to an extent of minor clinical relevance. It was also shown that beneficial effects of 0.01% atropine may not be obvious in each single case, which should be communicated with parents and resident ophthalmologists.

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“…Joachimsen et al observed a pupil dilation of 1 mm in children with 0.01% atropine therapy and negligible hypoaccomodation without an effect on near vision [ 17 ]. Sacchi et al reported photophobia in 9.6% as only detectable adverse event with 0.01% atropine, and data on pupil size were not presented [ 20 ]. Diaz-Llopis and Pinazo-Durán reported that in a 5-year observation period 2% of children treated with 0.01% atropine discontinued therapy due to photophobia, difficulties in reading, mydriasis or headache [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study

et al. 2021

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Purpose Based on findings of the Asian low-concentration atropine for myopia progression study, a concentration of 0.05% has been proposed as a good compromise between safety and efficacy for myopia control. However, no data on side effects have been published so far in Caucasian children receiving this dose. Methods Prior to commencement of bilateral atropine treatment with 0.05% atropine, 19 myopic children aged 5 to 15 years were treated in only one eye at bedtime leaving the other eye as a control. Pupil size, accommodation amplitude and near visual acuity were measured at 10:00 a.m. the next day and compared to the untreated contralateral control eye. The results were then compared to a cohort of 18 children whose treatment with 0.01% atropine commenced in a similar fashion. Results Twelve children (63%) reported visual impairment or reading difficulties. Anisocoria was 2.9 ± 1.1 mm. In comparison, 0.01% atropine led to a significantly less anisocoria of 0.8 ± 0.7 mm (p < 0.0001). Accommodation was decreased by − 4.2 ± 3.8 D in 0.05% atropine treated eyes, whereas 0.01% atropine induced hypoaccommodation of − 0.05 ± 2.5 D (p < 0.01). Near visual acuity was not significantly reduced in eyes treated with 0.05% atropine compared to 0.01% atropine (p = 0.26). Conclusion Compared to 0.01%, our data indicate stronger more relevant side effects of 0.05% topical atropine in young Caucasian children with progressive myopia as recently reported in Asian children, potentially compromising acceptance and compliance.

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Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients

Cited by 61 publications

References 31 publications

Analysis of Factors That May Affect the Effect of Atropine 0.01% on Myopia Control

Analysis of Factors That May Affect the Effect of Atropine 0.01% on Myopia Control

A retrospective analysis of the therapeutic effects of 0.01% atropine on axial length growth in children in a real-life clinical setting

Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study

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