Abstract
Purpose :
ATOM 2 study demonstrated a significant better efficacy of 0.01% atropine during the second year when compared with the first year, resulting in a clinically small difference in anti-myopia efficacy among 0.01%, 0.1%, and 0.5% at a two-year period. Our LAMP study demonstrated that 0.05% atropine conferred a better efficacy of myopia control compared with 0.025% atropine and 0.01% atropine over 1 year. In this report, we aimed to evaluate the efficacy and side effects of 0.05%, 0.025%, and 0.01% atropine over a 2-years period to determine the optimal concentration for myopia control.
Methods :
This is a two-year follow up of a double-blinded randomized controlled trial. 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 two years. Placebo group was switched to 0.05% atropine group during the second year follow up. Cycloplegic refraction, axial length (AL), accommodation amplitude, pupil diameter, and best-corrected visual acuity were measured at 4-month interval. Visual function questionnaire was administered at the end of second year visit. Linear mixed model was used to adjust the inter-eye interaction.
Results :
A total of 352 subjects completed two years follow-up. During the second year period, the mean spherical equivalent (SE) progression was 0.31D, 0.43D, and 0.49D in the 0.05%, 0.025%, and 0.01% atropine group, with respective axial length (AL) growth 0.19mm, 0.23mm, 0.24mm. Concentration-dependent response among 0.05%, 0.025%, and 0.01% atropine persisted over 2-year period.(Table 1A, Figure 1) Comparing with the first year, the second-year efficacy of 0.05% remained similar, but improved in 0.025% and 0.01% atropine group (Table 1B). For the placebo group, the myopia progression was significantly reduced after switching to 0.05% group. All concentrations remained well tolerated during the 2-year period. (Table 1A, Figure 1)
Conclusions :
Efficacy and side effects of atropine eye drops remained similar during the second year compared to first year follow up. 0.05% atropine eye drop is the optimal concentration over a 2-year period.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.