July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Low dose Atropine for Myopia Progression (LAMP) Study: A Double-blinded Randomized Placebo-Controlled Trial on atropine 0.05%, 0.025%, and 0.01%
Author Affiliations & Notes
  • Jason YAM
    The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Yuning Jiang
    The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Shu Min Tang
    The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Antony Law
    The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Footnotes
    Commercial Relationships   Jason YAM, None; Yuning Jiang, None; Shu Min Tang, None; Antony Law, None
  • Footnotes
    Support  Research Grants Council, Hong Kong (14111515 )
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 692. doi:
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      Jason YAM, Yuning Jiang, Shu Min Tang, Antony Law; Low dose Atropine for Myopia Progression (LAMP) Study: A Double-blinded Randomized Placebo-Controlled Trial on atropine 0.05%, 0.025%, and 0.01%. Invest. Ophthalmol. Vis. Sci. 2018;59(9):692.

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

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Abstract

Purpose : Low dose atropine is a promising therapy for myopia control, but its evidence has not been substantiated, and the optimal dosage has not been identified. We conducted a double-blinded, randomized placebo-controlled trial to establish the efficacy and safety of various low dose atropine (0.01%, 0.025% and 0.05%), and to identify the best optimal dosage for myopia control.

Methods : Children aged 4-12 years with myopia at least -1 Diopter (D), and astigmatism of -2.5 D or less, were randomized in 1:1:1:1 ratio to 0.05% atropine, 0.025% atropine, 0.01% atropine, and placebo drops, to be administered once nightly to both eyes for one year. Cycloplegic refraction, best corrected visual acuity, accommodation, pupil size, and axial length were measured at baseline, 2 weeks, and then every 4 months for one years. Visual Functioning Questionnaire-25 (VFQ-25) was administered at the one-year visit. Generalized estimating equation with robust standard errors was used to test the difference of the outcome measures among groups. Multiple comparisons were performed with Bonferroni adjustment.

Results : A total of 442 children were recruited. The one-year results were showed in Table 1. The mean myopia progression at one year was 0.26 D, 0.47 D, 0.58 D, and 0.82 D in the atropine 0.05%, 0.025%, 0.01%, and placebo groups, respectively. Myopia progression in all low dose atropine groups was significantly lower than that of placebo group in a dose-related pattern (p<.01). The mean increase in axial length was 0.21mm, 0.31mm, 0.33mm, and 0.43mm in the 0.05%, 0.025%, 0.01%, and placebo groups, respectively. Reduction in accommodation amplitude was -1.9 D, -1.6 D, -0.28 D, and -0.28 D in 0.05%, 0.025%, 0.01% and placebo, respectively. The change in pupil size under both photopic and scotopic conditions followed dose response (p<.01). The effect of atropine on accommodation amplitude and pupil size in all groups was small and clinically insignificant. VFQ-25, and change in near VA was similar among all groups.

Conclusions : Low dose atropine (0.05%, 0.025%, 0.01%) once nightly was effective in retarding the myopia progression, when compared with placebo group. Atropine 0.05% have a better efficacy and yet maintain a safe treatment profile than other groups.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Table 1. One-year results of 0.05% atropine, 0.025% atropine, 0.01% atropine, and placebo group.

Table 1. One-year results of 0.05% atropine, 0.025% atropine, 0.01% atropine, and placebo group.

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