The Association of Choroidal Thickening by Atropine With Treatment Effects for Myopia: Two-Year Clinical Trial of the Low-concentration Atropine for Myopia Progression (LAMP) Study

Yam, Jason C.; Jiang, You-Ming; Lee, Jackie; Li, Sherie; Zhang, Yuzhou; Sun, Wen; Ye, Nan; Wang, Yumeng; Yip, Benjamin Hon Kei; Kam, Ka Wai; Chan, Hei-Nga; Zhang, Xiu Juan; Young, Alvin L.; Tham, Clement C.; Cheung, Carol Y.; Chu, Wai Kit; Pang, Chi Pui; Chen, Li Jia

doi:10.1016/j.ajo.2021.12.014

Cited by 70 publications

(53 citation statements)

References 39 publications

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“…This could have important implications in myopia control research. For example, the low-concentration atropine for myopia progression study 53 recently showed that atropine eyedrops have a dose-dependent long-term choroidal thickening effect, which the authors suggested could help to slow the rate of axial elongation.…”

Section: Discussionmentioning

confidence: 99%

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Lee

Alonso‐Caneiro

Lingham

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to explore the age-related change in choroidal thickness (ChT) and test the hypothesis that baseline ChT is predictive of refractive error change in healthy young adults. Methods Participants underwent spectral-domain optical coherence tomography (SD-OCT) imaging and autorefraction at 20 (baseline) and 28 years old. The enhanced depth imaging mode on the SD-OCT was used to obtain images of the choroid. Scans were exported from the SD-OCT and analyzed with a custom software that automatically measures the central ChT. The longitudinal change in subfoveal ChT and association between baseline subfoveal ChT and 8-year change in refractive error (spherical equivalent) were determined using linear mixed models. Results In total, 395 eyes of 198 participants (44% men; 18–22 years at baseline) were included. Over 8 years, mean spherical equivalent decreased by 0.25 diopters (D) and axial length increased by 0.09 mm. Subfoveal choroid thickened by 1.3 µm/year (95% confidence interval [CI] = 0.6–2.0), but this was reduced by 0.9 µm/year (95% CI = 1.6–0.2) for every 1 mm increase in axial length. For every 10 µm increase in baseline ChT, average annual change in spherical equivalent and axial length reduced by 0.006 D/year and 0.003 mm/year, respectively. Conclusions In a community-based cohort of young adults, the choroid continued to change during early adulthood. Choroidal thickening was less in eyes that were longer at baseline, and the choroid thinned in eyes that showed myopia progression. The association between baseline ChT and longitudinal changes in spherical equivalent and axial length supports the hypothesis that ChT may be predictive of refractive error development and/or myopia progression.

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Section: Discussionmentioning

confidence: 99%

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Lee

Alonso‐Caneiro

Lingham

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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“…8 A and B). Among them, atropine has been reported to be used in clinical treatment of myopia ( Yam et al, 2021 ). Nicotinamide, a precursor of nicotinamide adenine dinucleotide (NAD+), has a high safety profile even at considerable doses and can attenuate obesity, aging, hearing loss, and vision loss ( Brown et al, 2014 ; Mendelsohn and Larrick, 2014 ; Poljsak and Milisav, 2018 ; Trammell et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

The dynamics of microbial community and flavor metabolites during the acetic acid fermentation of Hongqu aromatic vinegar

Tong

Yang

et al. 2022

Current Research in Food Science

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“…These changes could be explained by the cycloplegia-induced paralysis of the ciliary muscles, causing the ciliary processes to move outward and backward, shifting the lens–iris apparatus posteriorly, resulting in the deepening of the ACD, thinning of the lens, and shortening of the vitreous chamber [ 11 , 22 , 23 ]. Other studies reported an increase in subfoveal choroidal thickness during treatment with low-dose atropine, which would further contribute to the shortening of the VCD [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Low-Dose Atropine Induces Changes in Ocular Biometrics in Myopic Children: Exploring Temporal Changes by Linear Mixed Models and Contribution to Treatment Effect by Mediation Analyses

Hvid-Hansen

Jacobsen

Hjortdal

et al. 2023

JCM

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This study aimed to investigate changes in non-cycloplegic ocular biometrics during the initial six months of treatment with a 0.1% atropine loading dose and 0.01% atropine compared with a placebo and analyze their contribution to the treatment effect on cycloplegic spherical equivalent (SE) progression. The study was based on a randomized, double-masked, placebo-controlled, multicenter trial evaluating a 0.1% atropine six-month loading dose and 0.01% atropine in reducing myopic progression in Danish children. The treatment phase was 24 months, and the washout phase was 12 months. Parameters measured included changes in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and choroidal thickness (ChT), while cycloplegic SE and lens power were calculated. Longitudinal changes and contributions to treatment effects were analyzed using constrained linear mixed models and mediation analyses, respectively. After six months, AL was 0.13 mm shorter (95% confidence interval [CI], −0.18 to −0.07 [adjusted p < 0.001]) and 0.06 mm shorter (95% CI, −0.11 to −0.01 [adjusted p = 0.060]) with a 0.1% atropine loading dose and 0.01% atropine, respectively, compared to the placebo group. Similar concentration-dependent changes were found with ACD, LT, VCD, ChT, and cycloplegic SE. Although the treatment effects trended toward concentration-dependent responses, only the treatment effect mediated by AL at three months differed significantly between 0.01% atropine and a 0.1% atropine loading dose (adjusted p = 0.023). Several ocular biometrics, including AL, ACD, and LT, changed dose-dependently during low-dose atropine treatment. Moreover, the treatment effect of atropine on SE progression was mediated by a subset of ocular biometrics, mainly AL, with trends toward concentration dependency and distributional shifts over time.

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The Association of Choroidal Thickening by Atropine With Treatment Effects for Myopia: Two-Year Clinical Trial of the Low-concentration Atropine for Myopia Progression (LAMP) Study

Cited by 70 publications

References 39 publications

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

The dynamics of microbial community and flavor metabolites during the acetic acid fermentation of Hongqu aromatic vinegar

Low-Dose Atropine Induces Changes in Ocular Biometrics in Myopic Children: Exploring Temporal Changes by Linear Mixed Models and Contribution to Treatment Effect by Mediation Analyses

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