Five-Year clinical trial on Atropine for the Treatment of Myopia 2
Purpose: To compare the safety and efficacy of different concentrations of atropine eyedrops in controlling myopia progression over 5 years. Design: Randomized, double-masked clinical trial. Participants: A total of 400 children originally randomized to receive atropine 0.5%, 0.1%, or 0.01% once dai...
Saved in:
Main Authors: | , , |
---|---|
Other Authors: | |
Format: | Article |
Language: | English |
Published: |
2018
|
Subjects: | |
Online Access: | https://hdl.handle.net/10356/88006 http://hdl.handle.net/10220/46880 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Institution: | Nanyang Technological University |
Language: | English |
id |
sg-ntu-dr.10356-88006 |
---|---|
record_format |
dspace |
spelling |
sg-ntu-dr.10356-880062020-03-07T12:57:24Z Five-Year clinical trial on Atropine for the Treatment of Myopia 2 Chia, Audrey Lu, Qing-Shu Tan, Donald Lee Kong Chian School of Medicine (LKCMedicine) Atropine Eyedrops Myopia DRNTU::Science::Medicine Purpose: To compare the safety and efficacy of different concentrations of atropine eyedrops in controlling myopia progression over 5 years. Design: Randomized, double-masked clinical trial. Participants: A total of 400 children originally randomized to receive atropine 0.5%, 0.1%, or 0.01% once daily in both eyes in a 2:2:1 ratio. Methods: Children received atropine for 24 months (phase 1), after which medication was stopped for 12 months (phase 2). Children who had myopia progression (≥−0.50 diopters [D] in at least 1 eye) during phase 2 were restarted on atropine 0.01% for a further 24 months (phase 3). Main Outcome Measures: Change in spherical equivalent and axial length over 5 years. Results: There was a dose-related response in phase 1 with a greater effect in higher doses, but an inverse dose-related increase in myopia during phase 2 (washout), resulting in atropine 0.01% being most effective in reducing myopia progression at 3 years. Some 24%, 59%, and 68% of children originally in the atropine 0.01%, 0.1%, and 0.5% groups, respectively, who progressed in phase 2 were restarted on atropine 0.01%. Younger children and those with greater myopic progression in year 1 were more likely to require re-treatment. The lower myopia progression in the 0.01% group persisted during phase 3, with overall myopia progression and change in axial elongation at the end of 5 years being lowest in this group (−1.38±0.98 D; 0.75±0.48 mm) compared with the 0.1% (−1.83±1.16 D, P = 0.003; 0.85±0.53 mm, P = 0.144) and 0.5% (−1.98±1.10 D, P < 0.001; 0.87±0.49 mm, P = 0.075) groups. Atropine 0.01% also caused minimal pupil dilation (0.8 mm), minimal loss of accommodation (2–3 D), and no near visual loss compared with higher doses. Conclusions: Over 5 years, atropine 0.01% eyedrops were more effective in slowing myopia progression with less visual side effects compared with higher doses of atropine. NMRC (Natl Medical Research Council, S’pore) 2018-12-07T07:13:45Z 2019-12-06T16:53:56Z 2018-12-07T07:13:45Z 2019-12-06T16:53:56Z 2016 Journal Article Chia, A., Lu, Q.-S., & Tan, D. (2016). Five-Year clinical trial on Atropine for the Treatment of Myopia 2. Ophthalmology, 123(2), 391-399. doi:10.1016/j.ophtha.2015.07.004 0161-6420 https://hdl.handle.net/10356/88006 http://hdl.handle.net/10220/46880 10.1016/j.ophtha.2015.07.004 en Ophthalmology © 2016 American Academy of Ophthalmology. |
institution |
Nanyang Technological University |
building |
NTU Library |
country |
Singapore |
collection |
DR-NTU |
language |
English |
topic |
Atropine Eyedrops Myopia DRNTU::Science::Medicine |
spellingShingle |
Atropine Eyedrops Myopia DRNTU::Science::Medicine Chia, Audrey Lu, Qing-Shu Tan, Donald Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
description |
Purpose: To compare the safety and efficacy of different concentrations of atropine eyedrops in controlling myopia progression over 5 years. Design: Randomized, double-masked clinical trial. Participants: A total of 400 children originally randomized to receive atropine 0.5%, 0.1%, or 0.01% once daily in both eyes in a 2:2:1 ratio. Methods: Children received atropine for 24 months (phase 1), after which medication was stopped for 12 months (phase 2). Children who had myopia progression (≥−0.50 diopters [D] in at least 1 eye) during phase 2 were restarted on atropine 0.01% for a further 24 months (phase 3). Main Outcome Measures: Change in spherical equivalent and axial length over 5 years. Results: There was a dose-related response in phase 1 with a greater effect in higher doses, but an inverse dose-related increase in myopia during phase 2 (washout), resulting in atropine 0.01% being most effective in reducing myopia progression at 3 years. Some 24%, 59%, and 68% of children originally in the atropine 0.01%, 0.1%, and 0.5% groups, respectively, who progressed in phase 2 were restarted on atropine 0.01%. Younger children and those with greater myopic progression in year 1 were more likely to require re-treatment. The lower myopia progression in the 0.01% group persisted during phase 3, with overall myopia progression and change in axial elongation at the end of 5 years being lowest in this group (−1.38±0.98 D; 0.75±0.48 mm) compared with the 0.1% (−1.83±1.16 D, P = 0.003; 0.85±0.53 mm, P = 0.144) and 0.5% (−1.98±1.10 D, P < 0.001; 0.87±0.49 mm, P = 0.075) groups. Atropine 0.01% also caused minimal pupil dilation (0.8 mm), minimal loss of accommodation (2–3 D), and no near visual loss compared with higher doses. Conclusions: Over 5 years, atropine 0.01% eyedrops were more effective in slowing myopia progression with less visual side effects compared with higher doses of atropine. |
author2 |
Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Chia, Audrey Lu, Qing-Shu Tan, Donald |
format |
Article |
author |
Chia, Audrey Lu, Qing-Shu Tan, Donald |
author_sort |
Chia, Audrey |
title |
Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
title_short |
Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
title_full |
Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
title_fullStr |
Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
title_full_unstemmed |
Five-Year clinical trial on Atropine for the Treatment of Myopia 2 |
title_sort |
five-year clinical trial on atropine for the treatment of myopia 2 |
publishDate |
2018 |
url |
https://hdl.handle.net/10356/88006 http://hdl.handle.net/10220/46880 |
_version_ |
1681041516994232320 |