Safety and efficacy of atropine treatment for slowing myopia progression in children: a 5-year review

Authors

  • Sing Lok Charles Lau Department of Ophthalmology, United Christian Hospital, Hong Kong
  • Dorothy Shu Ping Fan Department of Ophthalmology, Hong Kong Sanatorium & Hospital
  • Kenneth Kai Wang Li Department of Ophthalmology, United Christian Hospital, Hong Kong

Keywords:

Atropine, Axial length, eye, Myopia, Refractive errors

Abstract

Aim: To report the efficacy and safety of atropine treatment (0.01% and 0.125%) in slowing myopia progression in children.

Methods: This is a retrospective non-interventional case series. All patients aged <18 years who received topical atropine for myopia control from 2011 to 2016 in the Hong Kong Sanatorium & Hospital were included for analysis. Myopia progression, atropine treatment, and other factors affecting treatment outcomes were analyzed. We also reported any adverse effects associated with atropine use.

Results: A total of 346 patients were recruited, with mean a follow-up period of 2.26±0.82 years. The patients had a mean reduction of myopia progression of 68.4% after atropine treatment (p<0.001). The mean myopia progression rate (in spherical equivalent) was -0.38±0.36 D/year, and the mean axial length elongation rate was 0.23±0.19 mm/year. More reduction of myopia progression was associated with baseline myopia progression of <-1 D/year (p<0.001) and initial atropine dosage of 0.125% (p<0.001). Reduction of myopia
progression was associated with starting age (p=0.041) and baseline myopia progression (p=0.004). Patients aged <6 years who received atropine treatment (n=17) showed reduction of myopia progression by 71.1%. Only mild adverse effects such as photophobia were reported.

Conclusion: Topical atropine is an efficacious and safe treatment for slowing myopia progression.

References

Chia A, Chua WH, Cheung YB, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology 2012;119:347-54.

Saw SM, Tong L, Chua WH, et at. Incidence and progression of myopia in Singaporean school children. Invest Ophthalmol Vis Sci 2005;46:51-7.

Fan DS, Lam DS, Lam RF, et al. Prevalence, incidence, and progression of myopia of school children in Hong Kong. Invest Ophthalmol Vis Sci 2004;45:1071-5.

Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network meta-analysis. Ophthalmology 2016;123:697-708.

Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006;113:2285-91.

Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology 2019;126:113-24.

Gong Q, Janowski M, Luo M, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis. JAMA Ophthalmol 2017;135:624-30.

Lin HJ, Wan L, Chen WC, Lin JM, Lin CJ, Tsai FJ. Muscarinic acetylcholine receptor 3 is dominant in myopia progression. Invest Ophthalmol Vis Sci 2012;53:6519-25.

Barathi VA, Kwan JL, Tan QS, et al. Muscarinic cholinergic receptor (M2) plays a crucial role in the development of myopia in mice. Dis Model Mech 2013;6:1146-58.

Lam CS, Edwards M, Millodot M, Goh WS. A 2-year longitudinal study of myopia progression and optical component changes among Hong Kong schoolchildren. Optom Vis Sci 1999;76:370-80.

Downloads

Published

2020-06-23

How to Cite

1.
Lau SLC, Fan DSP, Li KKW. Safety and efficacy of atropine treatment for slowing myopia progression in children: a 5-year review. Hong Kong J Ophthalmol [Internet]. 2020Jun.23 [cited 2020Oct.25];24(1):11-4. Available from: https://hkjo.hk/index.php/hkjo/article/view/255

Issue

Section

Original Articles