Treatment of childhood myopia with atropine eyedrops and bifocal spectacles.
BACKGROUND
Animal and human studies have suggested that muscarinic antagonists and bifocal spectacles may decrease the progression of myopia in children. The purpose of this study is to report the largest known series of patients treated simultaneously with bifocals and topical atropine.


METHODS
Retrospective, interventional, non-comparative case series.


METHODS
706 myopic children (296 boys and 410 girls, ages 6 to 16 years) were prescribed full cycloplegic spectacle corrections, with photochromic lenses and +2.25 diopter (D) reading adds in each eye. Both eyes were treated with atropine 1% drops once daily.


METHODS
Annual change in cycloplegic refractions of right eyes. Compliance with therapy was monitored by patient and parental report.


RESULTS
496 (70%) of the 706 patients reported full compliance with the treatment regimen, whereas the remaining 210 (30%) patients were partially compliant. The median interval of treatment was 3.62 years (range, 21 days-10.1 years). The mean rate of myopic progression was significantly less (P<0.001) in patients who were fully compliant with atropine therapy and bifocals (0.08 D/year) than in patients who were partially compliant with the treatment regimen (0.23 D/per year). No serious adverse effects were associated with atropine therapy.


CONCLUSIONS
Full compliance with topical atropine therapy and bifocal spectacles was associated with decreased progression of myopia compared to partial compliance with treatment. For each of the treated groups, the mean rate of myopic progression was significantly less (P<0.05) than the mean annual rates of myopic progression published for the pediatric population.
Chiang
M F
MF
The Wilmer Ophthalmological Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287-9028, USA.
Kouzis
A
A
Pointer
R W
RW
Repka
M X
MX
D000293:Adolescent; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D018450:Disease Progression; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D009216:Myopia / Q000503:physiopathology / Q000628:therapy*; D010349:Patient Compliance; D012189:Retrospective Studies; D016896:Treatment Outcome
D018727:Muscarinic Antagonists; D001285:Atropine