Abstract
Purpose :
Several randomized clinical studies (RTCs) have demonstrated the beneficial effects of low dose (0.01%) atropine eye drops on myopia progression in children. However, treatment effects may be different in a routine clinical setting.
Methods :
We performed a retrospective analysis of our clinical data from 80 atropine treated and 103 untreated children of white population in Germany with a wide range of myopic refractive errors and ages. Objective refraction and ocular biometry (anterior chamber depth, lens thickness, axial length) were determined at the initial and at later visits. As requested by the parents, children in the treatment group were asked to instill one drop of 0.01% atropine solution in each eye every evening at five days a week. Myopic children who did not undergo atropine treatment served as controls. All children were re-examined about one year later.
Results :
Myopic refractions (spherical equivalents) at baseline ranged from -0.625 to -15.25 D (-4.21 ± 2.90 D) in atropine treated children and from -0.125 to -9.375 D (-2.92 ± 1.77 D) in untreated children. Ages at the initial visits ranged from 3.2 to 15.5 years (10.1 ± 2.7 years) in the treated group and from 3.4 to 15.5 years (11.2 ± 3.0 years) in the untreated group. Myopia progression continued in both atropine treated and untreated children. Variability of progression rates was high. A two-factor ANOVA for age and atropine effects on axial length growth confirmed that eye growth rates generally declined with age (p<0.0001). Atropine had a significant inhibitory effect on axial eye growth (p<0.0015) which was independent of age. On average we observed 0.08 mm inhibition per year, equivalent to 28% less compared to average growth rate in untreated children. Interestingly, effects of atropine on refractive states were not significant.
Conclusions :
In this real-life clinical setting, the effects of 0.01% atropine were not very distinctive. Myopic progression in individuals did not show obvious differences between atropine treated and untreated children. A statistical analysis over the whole sample confirmed that atropine reduced axial length growth, but to an extent which is of minor clinical relevance. Under the given conditions, the beneficial effects of 0.01% atropine eye drops on myopia may not be obvious in each single child which should be communicated to parents and residents.
This is a 2021 ARVO Annual Meeting abstract.