June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017

Sustained topical delivery of very low-dose atropine avoids the periodic excessive pupil dilation, light sensitivity and blur of drop therapy
Author Affiliations & Notes
  • Charles D Leahy
    Amorphex Therapeutics LLC, Andover, Massachusetts, United States
  • Edward J Ellis
    Amorphex Therapeutics LLC, Andover, Massachusetts, United States
  • Jeanne Ellis
    Amorphex Therapeutics LLC, Andover, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Charles Leahy, Amorphex Therapeutics LLC (I), Amorphex Therapeutics LLC (E), Amorphex Therapeutics LLC 20160338947 (P); Edward Ellis, Amorphex Therapeutics LLC (I), Amorphex Therapeutics LLC (E), Amorphex Therapeutics LLC 20160338947 (P); Jeanne Ellis, 20160338947 (E), Amorphex Therapeutics LLC (I)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4467. doi:
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    • Get Citation

      Charles D Leahy, Edward J Ellis, Jeanne Ellis;
      Sustained topical delivery of very low-dose atropine avoids the periodic excessive pupil dilation, light sensitivity and blur of drop therapy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4467.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Atropine drops have been used in the treatment of myopia progression. The most effective concentrations cause excessive, fixed pupillary dilation, photophobia, near vision blur and possible toxic light levels to the retina, presenting obstacles to this treatment. We explored whether sustained, micro quantities of atropine could be released from a topical matrix device, as evidenced by continuous but modest pupil dilation, with preserved pupil functioning and minimal light sensitivity and visual blur.

Methods : Preliminary experiments indicated trial of a hundred-fold decrease in concentration from that which caused a typical clinical drop result of a fixed dilated pupil lasting over a week. The subject, CL, inserted one device in the left eye and wore it continuously for over 60 days. The other eye functioned as the untreated control. Pupil measurements were taken a least daily using a Jaeger Nearpoint Vision Card’s pupil gauge. Lighting conditions were varied to confirm the treated pupil’s constriction and dilation function.

Results : For the entire time that the device was worn, the treated eye had a clinically detectable larger pupil compared to the eye with no treatment for all measurements (avg 1.50 mm through 60 days, p<<.001, paired t-test). The 0.05% dose did not fix and dilate the pupil at any time during treatment. After moderate blur and mild glare the first evening of treatment only, there were no visual symptoms of light sensitivity or blur throughout the study.

Conclusions : The study established intraocular continuous very low dose atropine delivery, as demonstrated by an increased pupil size vs. the control eye at every measurement over 60 days. Dosing remained low enough to continuously prevent symptoms of blur and light sensitivity. That the pupil remained reactive to changes in ambient light, rather than fixed and dilated as with standard atropine eye drop dosing, we believe contributes to the comfort of such treatment. Any cycloplegic effect, while not detected in this patient, needs to be further investigated in the young myopic population. If confirmed by prospective clinical trials, these findings would offer novel treatments for myopia progression.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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