Short-term refractive and ocular parameter changes after topical atropine

Ho, Min-Chieh; Hsieh, Yi‐Ting; Shen, Edward; Hsu, Wei-Cherng; Cheng, Han-Chih

doi:10.4103/tjo.tjo_110_18

Cited by 16 publications

(9 citation statements)

References 26 publications

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“…We found that AL was controlled and even shortened within 4.8 months of treatment in the treated eye. This observation is consistent with that of previous studies, although the mechanism remains unclear 5 , 14 , 15 . However, since we cannot exclude data for the first 4.8 months given the retrospective nature of our study, we acknowledge that we may have overestimated the AL-retarding effect of atropine by using the outcome measure of the calculated annual changes in AL from short-term measurement of AL in some cases.…”

Section: Discussionsupporting

confidence: 94%

Evaluation of axial length to identify the effects of monocular 0.125% atropine treatment for pediatric anisometropia

Kao

Chuang

Lai

et al. 2021

Sci Rep

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The aim of the study is to determine the effects of monocular 0.125% atropine daily treatment on the longer axial length (AL) eyes in children with pediatric anisometropia. This was a retrospective cohort study. The charts of children with anisometropia (aged 6–15 years) who had a > 0.2-mm difference in AL between the two eyes were reviewed. Children who received monocular treatment of 0.125% atropine in the eye with longer AL were included for final analysis. The main outcome measure was the difference in AL between the two eyes after treatment. Regression analysis was used to model the changes in AL according to the time of treatment in both eyes. Finally, forty eyes in 20 patients (mean age 10.2 years) were included in the analyses. During the treatment period, AL was controlled in the treated eyes (p = 0.389) but elongated significantly in the untreated eyes (p < 0.001). The difference in AL between the treated and untreated eyes decreased from 0.57 to 0.22 mm (p < 0.001) after the 1-year treatment period. In the regression model, the best fit for the relationship between changes in AL and time during the treatment period in the treated eyes was the quadratic regression model with a concave function. In conclusion, these data suggest that 0.125% atropine daily is an effective treatment to reduce the interocular difference of AL in eyes with axial anisometropia. This pilot study provides useful information for future prospective and larger studies of atropine for the treatment of pediatric axial anisometropia.

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Section: Discussionsupporting

confidence: 94%

Evaluation of axial length to identify the effects of monocular 0.125% atropine treatment for pediatric anisometropia

Kao

Chuang

Lai

et al. 2021

Sci Rep

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“…The recruitment duration (X15) and total duration (X8) are significant factors predicting endpoint IOP. The recruitment duration (X15), one year before the termination of data collection, reflects the frequency and number of visits, which is indicative of a patient’s approach to medical care [ 30 , 31 , 32 ]. Because only for eyes were not prescribed atropine during recruitment, data from the recruitment duration can be considered as being from patients that had been taking atropine during the previous year.…”

Section: Discussionmentioning

confidence: 99%

“…However, long-term atropine application has raised concerns among some ophthalmologists [ 27 , 28 , 29 ]. Atropine can paralyze the pupillary muscle, increasing resistance and impeding the flow of the aqueous humor, which might increase intraocular pressure (IOP) [ 30 , 31 , 32 , 33 ]. We aimed to identify factors that predict incident IOP in patients with myopia after atropine use.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Effect of Topical Atropine Use for Myopia Control on Intraocular Pressure by Using Machine Learning

Chen

Jhou

et al. 2020

JCM

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Atropine is a common treatment used in children with myopia. However, it probably affects intraocular pressure (IOP) under some conditions. Our research aims to analyze clinical data by using machine learning models to evaluate the effect of 19 important factors on intraocular pressure (IOP) in children with myopia treated with topical atropine. The data is collected on 1545 eyes with spherical equivalent (SE) less than −10.0 diopters (D) treated with atropine for myopia control. Four machine learning models, namely multivariate adaptive regression splines (MARS), classification and regression tree (CART), random forest (RF), and eXtreme gradient boosting (XGBoost), were used. Linear regression (LR) was used for benchmarking. The 10-fold cross-validation method was used to estimate the performance of the five methods. The main outcome measure is that the 19 important factors associated with atropine use that may affect IOP are evaluated using machine learning models. Endpoint IOP at the last visit was set as the target variable. The results show that the top five significant variables, including baseline IOP, recruitment duration, age, total duration and previous cumulative dosage, were identified as most significant for evaluating the effect of atropine use for treating myopia on IOP. We can conclude that the use of machine learning methods to evaluate factors that affect IOP in children with myopia treated with topical atropine is promising. XGBoost is the best predictive model, and baseline IOP is the most accurate predictive factor for endpoint IOP among all machine learning approaches.

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“…AL shortening not only occurs in LLRL treatment, but also in the treatment of atropine or orthokeratology lens. [36][37][38][39] Anatomically, an increase in ChT mechanically pushes the retina forward, which naturally shortens the AL. 32,40 Moreover, the choroid is a highly vascularized tissue, and changes in the ChBF may affect the AL.…”

Section: Discussionmentioning

confidence: 99%

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

Cao,

Tian,

et al. 2024

JAMA Ophthalmol

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ImportanceTreatments are needed to slow progression of or reduce incidence of myopia.ObjectiveTo evaluate the efficacy and safety of daily 650-nm low-level red light (LLRL) for myopia treatment.Design, Setting, and ParticipantsSingle-masked, randomized clinical trial at 1 site in China. Baseline measurements were completed from August to September 2021. Participants were children aged 6 to 12 years with spherical equivalent error (SER) of −6 diopters (D) to 3 D. Data were analyzed from March to July 2023.InterventionsIrradiation daily with 650-nm LLRL for 3 minutes twice daily 4 or more hours apart or no intervention.Main Outcomes and MeasuresPrimary outcomes were changes in cycloplegia SER and axial length (AL) at 6- and 12-month follow-up visits. Safety was assessed on masked fundus photograph evaluations.ResultsA total of 336 children were randomly allocated into the LLRL group or control group in a 1:1 ratio. The control group contained 86 female patients (51.2%), and the treatment group contained 90 female patients (53.6%). The mean (SD) age, SER, and AL were 9.0 (1.9) years, −1.3 (1.5) D, and 23.8 (1.0) mm for all patients. A total of 161 (95.8%) in the LLRL group and 159 (94.6%) in the control group returned for the 6-month follow-up. A total of 157 (93.5%) in the LLRL group and 152 (90.5%) in the control group returned for the 12-month follow-up. Mean (SD) changes in SER were 0.15 (0.16) D and −0.26 (0.21) D for the LLRL group and the control group, respectively (difference, −0.41 D; 95% CI, −0.48 to −0.34 D; P &lt; .001), at 6 months and 0.24 (0.27) D and −0.65 (0.33) D for the LLRL group and the control group, respectively (difference, −0.89 D; 95% CI, −0.95 to −0.83 D; P &lt; .001), at 12 months. Mean (SD) changes in AL were −0.06 (0.08) mm and 0.13 (0.12) mm for the LLRL group and control group, respectively (difference, 0.19 mm; 95% CI, 0.16 to 0.22 mm; P &lt; .001), at 6 months and −0.11 (0.10) mm and 0.26 (0.16) mm for the LLRL group and control group, respectively (difference, 0.37 mm; 95% CI, 0.34 to 0.40 mm; P &lt; .001). Masked fundus photograph review did not identify retinal changes in either group.Conclusions and relevanceThese findings suggest daily use of 650-nm LLRL for 1 year can slow progression of SER and AL without safety concerns identified. Confirmation of these findings at independent sites seems warranted, as well as determining whether these effects can be sustained with or without continued treatment and whether LLRL has any effect on pathological myopia.Trial RegistrationChiCTR2200058963

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Short-term refractive and ocular parameter changes after topical atropine

Cited by 16 publications

References 26 publications

Evaluation of axial length to identify the effects of monocular 0.125% atropine treatment for pediatric anisometropia

Evaluation of axial length to identify the effects of monocular 0.125% atropine treatment for pediatric anisometropia

Evaluating the Effect of Topical Atropine Use for Myopia Control on Intraocular Pressure by Using Machine Learning

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

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