Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.ophtha.2011.07.031
Title: 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)
Authors: Chia, A.
Chua, W.-H.
Cheung, Y.-B. 
Wong, W.-L.
Lingham, A.
Fong, A.
Tan, D.
Issue Date: Feb-2012
Citation: Chia, A., Chua, W.-H., Cheung, Y.-B., Wong, W.-L., Lingham, A., Fong, A., Tan, D. (2012-02). 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 119 (2) : 347-354. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ophtha.2011.07.031
Abstract: Purpose: Our previous study, Atropine for the Treatment of Myopia 1 (ATOM1), showed that atropine 1% eyedrops were effective in controlling myopic progression but with visual side effects resulting from cycloplegia and mydriasis. The aim of this study was to compare efficacy and visual side effects of 3 lower doses of atropine: 0.5%, 0.1%, and 0.01%. Design: Single-center, double-masked, randomized study. Participants: A total of 400 children aged 612 years with myopia of at least -2.0 diopters (D) and astigmatism of -1.50 D or less. Intervention: Children were randomly assigned in a 2:2:1 ratio to 0.5%, 0.1%, and 0.01% atropine to be administered once nightly to both eyes for 2 years. Cycloplegic refraction, axial length, accommodation amplitude, pupil diameter, and visual acuity were noted at baseline, 2 weeks, and then every 4 months for 2 years. Main Outcome Measures: Myopia progression at 2 years. Changes were noted and differences between groups were compared using the HuberWhite robust standard error to allow for data clustering of 2 eyes per person. Results: The mean myopia progression at 2 years was -0.30±0.60, -0.38±0.60, and -0.49±0.63 D in the atropine 0.5%, 0.1%, and 0.01% groups, respectively (P=0.02 between the 0.01% and 0.5% groups; between other concentrations P > 0.05). In comparison, myopia progression in ATOM1 was -1.20±0.69 D in the placebo group and -0.28±0.92 D in the atropine 1% group. The mean increase in axial length was 0.27±0.25, 0.28±0.28, and 0.41±0.32 mm in the 0.5%, 0.1%, and 0.01% groups, respectively (P < 0.01 between the 0.01% and 0.1% groups and between the 0.01% and 0.5% groups). However, differences in myopia progression (0.19 D) and axial length change (0.14 mm) between groups were small and clinically insignificant. Atropine 0.01% had a negligible effect on accommodation and pupil size, and no effect on near visual acuity. Allergic conjunctivitis and dermatitis were the most common adverse effect noted, with 16 cases in the 0.1% and 0.5% atropine groups, and no cases in the 0.01% group. Conclusions: Atropine 0.01% has minimal side effects compared with atropine at 0.1% and 0.5%, and retains comparable efficacy in controlling myopia progression. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.
Source Title: Ophthalmology
URI: http://scholarbank.nus.edu.sg/handle/10635/109944
ISSN: 01616420
DOI: 10.1016/j.ophtha.2011.07.031
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