Topical atropine in retarding myopic progression and axial length growth in children with moderate to severe myopia: a pilot study.
OBJECTIVE
To study the safety and efficacy of topical 1% atropine eye ointment in retarding myopic progression in children with moderate to severe myopia.


METHODS
This was an interventional control study. Children (aged 5-10 years) with myopia of -3.00 diopters (D) or more were treated with 1% atropine ointment once daily for 1 year. Baseline and regular assessments of refractive errors by cycloplegic autorefraction and of axial length were done by ultrasound biometry, and the results were compared with data of control subjects.


RESULTS
Twenty-three children (mean age: 7.4 +/- 1.6 years) with moderate to severe myopia, being treated in the Hong Kong Eye Hospital of the Chinese University of Hong Kong, were recruited into the atropine group, and 23 children from the same eye clinic were matched with the study subjects with respect to age, sex, and initial spherical equivalent refraction, as controls. The initial refractive errors were -5.18 +/- 2.05 D and -5.12 +/- 2.33 D in the atropine and the control groups, respectively (P = 0.934). Myopic progression was significantly less (P = 0.005) in the atropine group (+0.06 +/- 0.79 D) than in the control group (-1.19 +/- 2.48 D). Axial length increase was also significantly smaller in the atropine group (0.09 +/- 0.19 mm) than in the control group (0.70 +/- 0.63 mm) (P = 0.004). One child (4.3%) developed an allergic reaction. No other major adverse effects related to the treatment were noted.


CONCLUSIONS
Topical 1% atropine ointment is a safe and effective treatment for retarding myopic progression in moderate to severe myopia. Further large-scale randomised controlled study with longer follow-up seems warranted.
Fan
Dorothy S P
DS
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China. dorothyfan@cuhk.edu.hk
Lam
Dennis S C
DS
Chan
Carmen K M
CK
Fan
Alex H
AH
Cheung
Eva Y Y
EY
Rao
Srinivas K
SK
D000287:Administration, Topical; D001285:Atropine / Q000008:administration & dosage* / Q000009:adverse effects; D001699:Biometry; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005123:Eye / Q000000981:diagnostic imaging / Q000254:growth & development*; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage* / Q000009:adverse effects; D009216:Myopia / Q000188:drug therapy* / Q000503:physiopathology; D009824:Ointments; D010865:Pilot Projects; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014463:Ultrasonography
D009184:Mydriatics; D009824:Ointments; D001285:Atropine