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Jan Roelof Polling, Gentiana Martinaj, Astrid van der Schans, Ruben G.W. Kok, Willem Tideman, Caroline C W Klaver; Effectiveness study of atropine for progressive myopia in Europeans; Two year follow up. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Randomized controlled trials have shown the efficacy of atropine for progressive myopia, and this treatment has become the preferred practice pattern for this condition in many Asian countries. This study explores the two year effectiveness of atropine 0.5% treatment for progressive high myopia and adherence to therapy in a clinical setting in a non-Asian country.
We performed an effectiveness study of atropine eye drops for progressive myopia in Rotterdam, the Netherlands. We included 205 children (mean age 9.8 yrs. ± 3.3) of European (n=138; 67.3%), Asian (n=51; 24.9%) and African (n=16; 7.8%) descent, performed a standardized eye examination including cycloplegic refraction and axial length at baseline, prescribed atropine eye drops 0.5% daily, and examined the children every 6 months at follow up. Children were prescribed photochromic multifocal glasses at the initiation of therapy. We compared progression rate before and after initiation of therapy with student t-test, and assessed which factors were associated with prolongation of therapy with logistic regression analysis.
Mean spherical equivalent (SE) at baseline was -6.15D ±3.59; mean annual progression rate before treatment -1.0D/yr; and the proportion of high myopes (SE ≤-6.0D) 40,5%. Median follow up was 23,6 months. Of the 205 children, 35 (17,1%) ceased therapy, of whom 24 within the first year of treatment. The mean progression rate of SE diminished substantially during the first year -0.24D ± 1.1 and the second year -0.51D ±0.64 (p=0.03). Age was significantly associated with continuation of therapy (p=0.01); the odds of ceasing atropine therapy were 0.5 time lower in children who started therapy before the age of 11 years.
Despite photophobia and lack of accommodation, our study shows that atropine can be an effective and sustainable treatment for progressive myopia also in the Western world. Younger children had the highest chance of successful implementation of this therapy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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