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Jan Roelof Polling, Astrid van der Schans, Hoi-Lam Wong, Willem Tideman, Sjoukje E Loudon, Caroline Klaver; A three year follow-up study of atropine treatment for progressive myopia in Europeans. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2387. doi: https://doi.org/.
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Atropine is the most effective treatment for myopia at short term. Rebound growth however, is a threat to the long-term benefit. This study explores the three year efficacy of atropine 0.5% treatment for progressive high myopia in a clinical setting, and the risk factors for poor response.
We performed an effectiveness study of atropine eye drops for progressive myopia in a single university clinic in Rotterdam, the Netherlands. Since 2011, 218 children have been treated with atropine 0.5% daily for their progressive myopia. For the current analysis, we included children who had 3 year consecutive data using atropine eye drops 0.5% daily (N=58). A standardized eye examination, including cycloplegic refraction and axial length at baseline was performed with follow up examinations every 6 months. Logistic regression analysis was used to evaluate the contribution of clinical factors associated with progression of myopia during atropine treatment.
At baseline, children were 9.7 (SD 3.3) years old with median spherical equivalent (SE) of -5.88D (IQR 3.94) and axial length (AL) 25.31mm (IQR 1.17). Half of the children already had high myopia (≤-6.0D), and the mean annual progression before treatment was -1.1D (IQR 0.97); During the first year of treatment, the annual progression was reduced to a median SE of 0.00D (IQR0.88) and AL 0.13mm (IQR 0.29), second year -0.50D (IQR0.69) and AL 0.14mm (IQR 0.28), third year -0.38D (IQR0.75) and AL 0.10mm (IQR 0.24). Risk factor for poor response (OR 3.26, 95% CI, 1.09 to 4.59, P = 0.02) was a younger age at start of therapy after correcting for gender, age of onset, and degree of myopia.
Overall, over a 3 year period atropine has an inhibiting effect on SE and AL although most treatment effect was seen in the first year. In younger children atropine treatment was less effective and may need to be combined with additional interventions to accomplish a more significant inhibition of 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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