Abstract
Purpose :
The purpose of this study is to determine the efficacy of Atropine 0.025% (A0.025%) in clinical practice.
Methods :
201 children were started on A0.025% between July 2021 and March 2022 at the Singapore National Eye Centre. Information collected included demographics (age, gender, ethnicity), refractive error and axial lengths (AL) done 6-12 months prior, at baseline, and 6-12 months after initiating A0.025%. Subjects were divided into 3 groups: (A) Children still progressing on Atropine 0.01% daily, who were changed to A0.025% ON; (B) Children previously on A0.01% BD, who were changed to A0.025% ON; and (C) Children started on A0.025% ON as first-line therapy. The rate of change in Spherical Equivalent (SE) and AL per year was calculated pre- and post- start of treatment.
Results :
A total of 166 children were included in the study (68, 34 and 64 in Groups A, B, and C respectively). Group A and B were similar in age (10.3 ± 1.9 years and 10.8 ± 1.7 years respectively, p = 0.332), and SE and AL at baseline were -5.2 ± 2.9 D and 25.07 ± 0.90 mm respectively (Group A); -6.0 ± 2.9 D and 25.36 ± 0.95 mm (Group B). Children in Group C were significantly younger (8.4 ± 1.4 years, p < 0.001) and less myopic at baseline (SE -3.9 ± 1.7 D, AL 24.46 ± 0.77, p < 0.001).
Children previously on A0.01% (Group A) had significantly less increase in SE (-0.98 ± 0.71 versus -0.15 ± 0.79 D/year, p <0.001), and AL (0.41 ± 0.27 vs 0.27 ± 0.27 mm/y, p=0.004) after starting A0.025%. Children who were converted from A0.01% twice a day to A0.025% daily (Group B) also demonstrated significantly less progression in SE (-0.63 ± 0.54 vs -0.31 ± 0.74 D/year, p <0.001) and AL (0.27 ± 0.16 vs 0.13 ± 0.19 mm/year, p < 0.001). Children who were started on A0.025% without prior treatment (Group C) progressed at a rate of -0.22 ± 0.80 D/y or 0.22 ± 0.28 mm/y.
The majority of subjects in our study tolerated A0.025% with minimal side effects. Side effects were reported in 9 patients (5.4%). Blurring of vision was the most common side effect (n=4; 2.4%) followed by stinging/discomfort (n=2; 1.2%), itch (n=2; 1.2%), and glare (n=1; 0.60%). No serious or severe side effects were reported during the follow up period.
Conclusions :
The Atropine 0.025% dose was clinically well-tolerated and quite effective, with a low side effect profile.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.