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Juan Huang, Jeffrey J Walline, Donald O Mutti, Lisa A Jones-Jordan; Effect of 0.01% atropine and soft bifocal contact lens on vision and vision-related outcomes over two weeks. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3403. doi: https://doi.org/.
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Both atropine and soft bifocal contact lenses (SBCL) have been shown to slow myopia progression. This study aims to investigate the short-term effect of a combination treatment of atropine and SBCL on visual acuity (VA), accommodative lag, near phoria, and pupil size.
49 children aged 7 to 11 years received daily combination treatment of 0.01% atropine (one drop in each eye before bed) and +2.50-D add SBCL for two weeks. The VA at distance and near was measured binocularly using logarithmic VA charts. Phoria at near was measured using the Modified Thorington test, and monocular accommodative lag was evaluated using Grand Seiko WAM-5500 Autorefractor while subjects viewed 20/125 size letters at 33 cm. The subjects wore best-corrected manifest refraction in trial frame for baseline measurements and best-corrected SBCL for post-treatment measurements. Photopic and mesopic pupil size was assessed using the NeurOptics VIP-200 Pupillometer. Paired t-tests were used to compare data pre- and post-treatment.
After two weeks of treatment, the high-contrast VA at distance was not significantly different from baseline (-0.02 ± 0.07 for both; p = 0.44), whereas low-contrast VA at distance was significantly decreased compared to baseline (baseline = +0.09 ± 0.07, post-treatment = +0.16 ± 0.08; p < 0.01). The high-contrast VA at near was not significantly different between pre- and post-treatment (baseline = -0.08 ± 0.07, post-treatment = -0.07 ± 0.08; p = 0.39). The Modified Thorington test revealed significantly more exophoria (negative values) at post-treatment than at baseline (baseline = -0.5 ± 6.9 PD, post-treatment = -2.7 ± 6.7 PD; p = 0.01). However, the accommodative lag at baseline was not significantly different from post-treatment (baseline = 1.34 ± 0.45 D, post-treatment = 1.40 ± 0.54 D; p = 0.62). The pupil size was not significantly different between pre- and post-treatment for either the photopic (5.4 ± 0.7 mm for both; p = 0.74) or mesopic condition (6.6 ± 0.6 mm for both; p = 0.53). Surveys completed by parents indicated the subjects wore SBCL 77 ± 22% of waking hours and used 0.01% atropine 6.4 ± 0.7 days per week.
Two weeks of treatment with 0.01% atropine and SBCL induced more exophoria at near and decreased low-contrast VA at distance. Both the anticholingergic effect of atropine and add power of SBCL could contribute to these changes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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