Abstract
Purpose :
Low-dose atropine [primarily 0.01%(A01) and 0.05%(A05)] reported to affect pupil size, accommodation, optical properties of cornea and lens which can compromise the image quality. The aim of this prospective blinded randomized parallel group study was to evaluate and compare the effect of atropine 0.01% vs 0.05% after 1 year on higher order aberrations(HOAs), retinal image quality and contrast sensitivity at different level of spatial frequencies among progressive myopic children.
Methods :
HOAs of 160 children (aged: 6-14yr, refractive error: -1D to -6D) recruited in a parallel-group, blinded, randomized trial [80 each receiving A01 and A05 once at night for 1 year] were measured using itracey wavefront aberrometry at baseline and 1 year follow-up visit. Retinal image quality was assessed using point spread function and represented in terms of Strehl-ratio. Contrast sensitivity over wide range of spatial frequencies (5, 10 & 15 cycles per degree(cpd)) measured objectively through modular transfer function(MTF). Primary analysis was based on intention-to-treat principle.
Results :
There was no significant difference noted in age(8.9±2.8yr vs 9.1±2.5yr), myopia(-3.2±1.3 vs -3.5±1.4D) and biometric parameters between A01 vs A05 at baseline (p>0.05 for all). The mean total HOAs were not increased significantly in A01[0.31±0.12µ(baseline) vs 0.34±0.14µ(1 year); p:0.1] and A05[0.3±0.11µ(baseline) vs 0.36±0.16µ(1 year); p:0.07] group after 1 year; but change in HOA was significant between the two groups after 1 year(p:0.046). The A05 shows significant decrease in Strehl-ratio as compared to A01(p: 0.041). The change in MTF was found significant at 10cpd [-0.12±0.05; p:0.03(A01) and -0.14±0.05; p:0.02(A05)] and 15cpd [-0.09±0.04; p:0.042(A01) and -0.12±0.04; p:0.037(A05)] at 1-year follow-up when compared to baseline but not at 5cpd [-0.04±0.02; p:0.06(A01) and -0.04±0.02; p:0.07(A05)].
Conclusions :
The effect of atropine on HOAs and retinal image quality is dose dependent. A01 and A05 affects contrast sensitivity at higher spatial frequencies. Objectively, children receiving A05 perceive poorer image quality compared to children receiving A01. Quantifying wavefront aberration and advanced visual function provides, objective assessment of quality of vision of children; and may aids to understand/develop the myopia correction methods.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.