Abstract
Purpose :
To determine the effect of 0.01%, 0.03%, and 0.05% atropine on pupil size and binocular vision function in children aged 6 to 17 years.
Methods :
Forty-six children (28 girls and 18 boys) aged 6 to 17 years were randomized into 4 groups: placebo (n= 10), 0.01% (n=13), 0.03% (n= 11), or 0.05% (n= 12) atropine. One drop of atropine was administered into each eye once. The following measurements were collected before applying atropine and 30 minutes, 60 minutes, and 24 hours following application of atropine: pupil size in bright and dim illumination, associated phoria by cover test at distance and near, near point of convergence (NPC) break and recovery, 5 times repeat of NPC (stamina), NPC through red and green glasses (fragility), negative fusional vergence at near, and positive fusional vergence at near. Repeated measures ANOVA with post hoc comparison was performed to determine the effect of 0.01%, 0.03%, and 0.05% atropine eye drops on binocular vision measurement at each time point.
Results :
The mean age of participants was 10.73 ±3.01 years. Average spherical equivalence by cycloplegic refraction was -1.70 ± 1.98 D and -1.72 ± 2.10 D, OD and OS respectively. Difference in pupil diameters in bright and dim illumination was statistically significant when comparing all 3 atropine groups to placebo group over time (P< 0.001). Atropine eye drops had the most effect on pupil diameter 60 mins after installation (P<0.001). Pupil diameter was partially recovered at 24 hours with no statistical significance compared to the 30-minute time point (P >0.05), although still significantly different from baseline in the 0.03% atropine group (P=0.002). In the 0.01% and 0.05% atropine groups pupil diameter fully recovered after 24 hours with no significant difference from baseline (Ps>0.05). There was no significant difference in binocular vision measurements including associated phoria, NPC, NPC stamina and fragility, negative fusional vergence, and positive fusional vergence(all Ps >0.05)
Conclusions :
Pupil size was significantly enlarged by 0.01%, 0.03%, and 0.05% atropine in both dim and bright illumination with more effect at 60 minutes after application. However, low dose atropine eye drops have no effect on binocular vision measurements. Thus, in respect to binocular vision, it is relatively safe to use low-dose atropine to treat myopia progression in children aged 6 to 17 years.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.