Purchase this article with an account.
W.–H. Chua, D. Tan, V. Balakrishnan, Y.–H. Chan, ATOM Study Group; Progression of Childhood Myopia Following Cessation of Atropine Treatment . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4625.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose:The Atropine in the Treatment Of Myopia (ATOM) study demonstrated that topical treatment with atropine can slow progression of myopia over a two–year period by almost 80% compared with no treatment (Invest Ophthalmol Vis Sci 2003;44:E–Abstract 3119). To date, however, there is a paucity of data on the progression of myopia after stopping treatment. We now report the one year post–treatment results from the study. Methods: Four hundred children aged 6–12 years, with myopia of –1 D to –6 D, were enrolled after informed consent and randomly assigned with equal probability to receive either 1% atropine eye drop or Isoptotears once nightly. Only one eye of each child was chosen (also via randomization) for treatment. The fellow untreated eyes acted as natural controls. Each subject was treated for 2 years and thereafter followed–up at six–monthly intervals for another year. At each visit, cycloplegic autorefraction (primary outcome measure) was performed. Results: Of the 332 (83.0%) subjects who completed the one year follow–up after cessation of treatment, 158 were from the atropine group and 174 from the placebo group. In the atropine–treated eyes, the mean myopia progression in the third year was –1.10 D (SD = 0.58 D), and in the placebo–treated eyes, it was –0.39 D (SD = 0.38 D)(p < 0.001). Much of the myopia progression in the atropine–treated eyes occurred between 24 and 30 months (–0.73 D; SD = 0.40 D) compared with that between 30 and 36 months (–0.38 D; SD = 0.35 D). In the placebo–treated eyes, the increase in myopia during the third year was fairly constant, with progression of –0.20 D (SD = 0.32 D) between 24 and 30 months and –0.19 D (SD = 0.29 D) between 30 and 36 months. Overall, however, the mean progression of myopia after 3 years was still lower in the atropine–treated eyes (–0.95 D; SD = 0.78 D) than in the placebo–treated eyes (–1.58 D; SD = 0.86 D)(p < 0.001). Conclusions: Following the cessation of atropine treatment, there appears to be an initial increased rate of myopia progression. It is postulated that this could in part be due to the loss of atropine–induced cycloplegic effect. Longer follow–up is necessary to determine the trend in progression of myopia.
This PDF is available to Subscribers Only