Abstract
Purpose :
The effect on spherical equivalent (SE) was better than that on axial length (AL) in children receiving 0.01% atropine eye drop, both in the ATOM2 study and our LAMP study. One postulation for this discrepancy was attributed to the corneal effect of atropine eye drops. Based on LAMP phase one data, this report aimed to evaluate corneal parameters change in placebo, 0.01%, 0.025%, and 0.05% atropine treated eyes over one year.
Methods :
A total of 766 eyes in 383 children aged 4 to 12 years who have completed the first year follow up were included. Children were assigned 1:1:1:1 randomly to receive 0.05% atropine, 0.025% atropine, 0.01% atropine, or a placebo agent in both eyes daily for 1 year. Cycloplegic auto-refraction, and ocular biometry measured by IOL Master were performed at the initial visit, 2 weeks, 4 months, 8 months, and 12 months. By using linear mixed model, within group and between group analysis of change in corneal parameters were defined by the difference from baseline and the corresponding follow-up values, respectively.
Results :
After one year, the average K change was 0.011D, 0.002D, 0.004D, and 0.025D in the placebo group, 0.01% atropine group, 0.025% atropine group, and 0.05% atropine group respectively. (Table) Only 0.05% atropine group showed a significant change in average K over 1 year (p<0.001). Flattest K (K1) was reduced by 0.066D, 0.068D, 0.066D, and 0.105D, respectively(p<0.001), while steepest K (K2) increased by 0.088D, 0.072D, 0.074D, and 0.055D. (Table) Change in average K and K1 had a significant difference between 0.05% atropine and placebo groups. (Table) Concentration-dependent response on average K and corneal curvature were observed among the atropine groups. No significant difference was found in K2, CA, and ACD between group.
Conclusions :
We demonstrated a clinically small decrease of average K and K1 in 0.05% atropine group compared to placebo group, but not in 0.01% atropine group over one year. Concentration-dependent response on corneal effect was observed. With these clinically small corneal effect, anti-myopia effect of atropine act mainly on axial length but not on cornea.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.