Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/88006
Title: Five-Year clinical trial on Atropine for the Treatment of Myopia 2
Authors: Chia, Audrey
Lu, Qing-Shu
Tan, Donald
Keywords: Atropine Eyedrops
Myopia
DRNTU::Science::Medicine
Issue Date: 2016
Source: Chia, A., Lu, Q.-S., & Tan, D. (2016). Five-Year clinical trial on Atropine for the Treatment of Myopia 2. Ophthalmology, 123(2), 391-399. doi:10.1016/j.ophtha.2015.07.004
Series/Report no.: Ophthalmology
Abstract: Purpose: To compare the safety and efficacy of different concentrations of atropine eyedrops in controlling myopia progression over 5 years. Design: Randomized, double-masked clinical trial. Participants: A total of 400 children originally randomized to receive atropine 0.5%, 0.1%, or 0.01% once daily in both eyes in a 2:2:1 ratio. Methods: Children received atropine for 24 months (phase 1), after which medication was stopped for 12 months (phase 2). Children who had myopia progression (≥−0.50 diopters [D] in at least 1 eye) during phase 2 were restarted on atropine 0.01% for a further 24 months (phase 3). Main Outcome Measures: Change in spherical equivalent and axial length over 5 years. Results: There was a dose-related response in phase 1 with a greater effect in higher doses, but an inverse dose-related increase in myopia during phase 2 (washout), resulting in atropine 0.01% being most effective in reducing myopia progression at 3 years. Some 24%, 59%, and 68% of children originally in the atropine 0.01%, 0.1%, and 0.5% groups, respectively, who progressed in phase 2 were restarted on atropine 0.01%. Younger children and those with greater myopic progression in year 1 were more likely to require re-treatment. The lower myopia progression in the 0.01% group persisted during phase 3, with overall myopia progression and change in axial elongation at the end of 5 years being lowest in this group (−1.38±0.98 D; 0.75±0.48 mm) compared with the 0.1% (−1.83±1.16 D, P = 0.003; 0.85±0.53 mm, P = 0.144) and 0.5% (−1.98±1.10 D, P < 0.001; 0.87±0.49 mm, P = 0.075) groups. Atropine 0.01% also caused minimal pupil dilation (0.8 mm), minimal loss of accommodation (2–3 D), and no near visual loss compared with higher doses. Conclusions: Over 5 years, atropine 0.01% eyedrops were more effective in slowing myopia progression with less visual side effects compared with higher doses of atropine.
URI: https://hdl.handle.net/10356/88006
http://hdl.handle.net/10220/46880
ISSN: 0161-6420
DOI: 10.1016/j.ophtha.2015.07.004
Rights: © 2016 American Academy of Ophthalmology.
Fulltext Permission: none
Fulltext Availability: No Fulltext
Appears in Collections:LKCMedicine Journal Articles

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