Efficacy and safety of atropine to control childhood myopia progression
DOI:
https://doi.org/10.12775/JEHS.2022.12.08.014Keywords
atropine, childhood, myopiaAbstract
Introduction: Nearsightedness is one of the most common eye defects in people all over the world. If left untreated, it leads to a number of serious eye complications that can result in irreversible loss of vision. It is estimated that by 2050. Half of humanity will be burdened with this disadvantage, so it has become a priority to try to find ways to prevent and treat myopia, among which the administration of atropine drops is very effective.
Aim of the study: The aim of this study is to evaluate the safety and efficacy of atropine in controlling the progression of myopia and to investigate the relationship between the dose of atropine and the effectiveness of controlling the progression of myopia.
Material and methods: The PubMed and Google Scholar databases were used to review the literature.
Results: Eye drops with 1% atropine showed the greatest efficacy in the control of myopia. However, their use was limited due to the occurrence of side effects such as impaired accommodation and photophobia. In the ATOM 2 study, which investigated the use of atropine in a variety of concentrations, it was found that 0.01% is the optimal concentration with good efficacy and minimal side effects. One of the breakthroughs was the LAMP study using atropine at a concentration of 0.05%, 0.025%, 0.01% in eye drops. This study provided evidence for the first time that low-concentration atropine is effective compared with placebo in myopia. In addition, both efficacy and side effects followed a concentration-dependent response ranging from 0.01% to 0.05% of atropine. Among them, 0.05% of atropine was the optimal concentration to achieve the best efficacy and safety profile.
Conclusion: Low concentration of atropine is effective in the control of myopia. Its widespread use can help prevent the progression of myopia. However, further investigation of the rebound phenomenon and a long term, individualized approach to treatment are warranted.
References
Fricke TR, Jong M, Naidoo KS, et al. Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling. Br J Ophthalmol. 2018;102(7):855-862.
Ma Y, Qu X, Zhu X, et al. Age-specific prevalence of visual impairment and refractive error in children aged 3-10 years in Shanghai, China. Invest Ophthalmol Vis Sci. 2016;57(14):6188-6196.
Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res. 2021 Jul;83:100923. doi: 10.1016/j.preteyeres.2020.100923. Epub 2020 Nov 27. PMID: 33253901.
Arevalo JF, Ramirez E, Suarez E, Antzoulatos G, Torres F, Cortez R, et al. Rhegmatogenous retinal detachment after laser-assisted in situ keratomileusis (LASIK) for the correction of myopia. Retina 2000;20:338-41.
Arevalo JF, Azar-Arevalo O. Retinal detachment in myopic eyes after laser in situ keratomileusis. Am J Ophthalmol 2000;129:825-6.
Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL. Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 1984;91:1573-81.
Steidl SM, Pruett RC. Macular complications associated with posterior staphyloma. Am J Ophthalmol 1997;123:181-7.
Vongphanit J, Mitchell P, Wang JJ. Prevalence and progression of myopic retinopathy in an older population. Ophthalmology 2002;109:704-11.
Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology 1999;106:2010-15.
Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050 Holden, Brien A. et al., Ophthalmology, Volume 123, Issue 5, 1036–104.
The impact of myopia and high myopia. Report of the Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia. (2015).
Fu Y, Geng D, Liu H, Che H. Myopia and/or longer axial length are protective against diabetic retinopathy: a meta-analysis. Acta Ophthalmol 2016; 94: 346-352.
C. Y. Mak, J. C. Yam, L. J. Chen, S. M. Lee, and A. L. Young, “Epidemiology of myopia and prevention of myopia progression in children in East Asia: a review,” Hong Kong Medical Journal, vol. 24, pp. 602–609, 2018.
I. G. Morgan, A. N. French, R. S. Ashby et al., “The epidemics of myopia: aetiology and prevention,” Progress in Retinal and Eye Research, vol. 62, pp. 134–149, 2018.
I. G. Morgan, K. Ohno-Matsui, and S.-M. Saw, “Myopia,” The Lancet, vol. 379, no. 9827, pp. 1739–1748, 2012.
Loughman J, Flitcroft DI. The acceptability and visual impact of 0,01% atropine in Caucasian population. Br J Ophthalmol 2016; 100: 1525-1529.
I. G. Morgan, K. Ohno-Matsui, and S.-M. Saw, “Myopia,” The Lancet, vol. 379, no. 9827, pp. 1739–1748, 2012.
J. Cooper and A. V. Tkatchenko, “A review of current concepts of the etiology and treatment of myopia,” Eye and Contact Lens: Science and Clinical Practice, vol. 44, no. 4, pp. 231–247, 2018.
L. Spillmann, “Stopping the rise of myopia in Asia,” Graefe’s Archive for Clinical and Experimental Ophthalmology, vol. 258, no. 5, pp. 943–959, 2020.
Kumaran A., Htoon H. M., Tan D., Chia A. Analysis of changes in refraction and biometry of atropine- and placebo-treated eyes. Investigative Opthalmology & Visual Science . 2015;56(9):5650–5655. doi: 10.1167/iovs.14-14716.
Li F. F., Kam K. W., Zhang Y., et al. Differential effects on ocular biometrics by 0.05%, 0.025%, and 0.01% atropine: low-concentration atropine for myopia progression study. Ophthalmology . 2020;127:1603–1611. doi: 10.1016/j.ophtha.2020.06.004.
Yam J. C., Jiang Y., Tang S. M., et al. Low-concentration atropine for myopia progression (LAMP) study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology. 2019;126:113–124. doi: 10.1016/j.ophtha.2018.05.029.
Yam J. C., Li F. F., Zhang X., et al. Two-year clinical trial of the low-concentration atropine for myopia progression (LAMP) study: phase 2 report. Ophthalmology. 2020;127:910–919. doi: 10.1016/j.ophtha.2019.12.011.
Yi S., Huang Y., Yu S. Z., Chen X. J., Yi H., Zeng X. L. Therapeutic effect of atropine 1% in children with low myopia. Journal of AAPOS: The Official Publication of the American Association for Pediatric Ophthalmology and Strabismus . 2015;19:426–429. doi: 10.1016/j.jaapos.2015.04.006.
D. Hasket. On the Atropine Treatment of Acquired and Progressive Myopia. Trans Am Ophthalmol Soc 1874;2: 139–154.
R.H. Bedrossian. The effect of atropine on myopia. Ann Ophthalmol 1971;3(8): 891–897 14. J.A. Dyer. Role of Cycloplegics in Progressive Myopia. Ophthalmology 1979;86(5): 692–694.
Yen MY, Liu JH, Kao SC, et al. Comparison of the effect of atropine and cyclopentolate on myopia. Ann Ophthalmol 1989; 21:180–182.
Shih YF, Chen CH, Chou AC, et al. Effects of different concentrations of atropine on controlling myopia in myopic children. J Ocul Pharmacol Ther 1999; 15:85–90.
Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006; 113:2285–2291.
A. Chia, W.H. Chua, Y.B. Cheung et al. Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0,5%, 0,1%, and 0,01% Doses (Atropine for the treatment of Myopia 2). Ophthalmology 2012;119(2): 347–354.
Gong Q, Janowski M, Luo M, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis. JAMA Ophthalmol 2017; 135:624–630.
J.C. Yam i wsp.: Low-Concentration Atropine for Myopia Progression (LAMP) Study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology, 2019; 126: 113–124.
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Copyright (c) 2022 Martyna Lewkowicz, Katarzyna Nowakowska, Mateusz Pawlina, Karolina Raksa, Karolina Ziętara, Magdalena Kozioł
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