title: Risk factors for progressive myopia in the atropine therapy for myopia study.
abstract: OBJECTIVE
  To investigate variables associated with myopic progression despite treatment in the Atropine in the Treatment of Myopia Study.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Two hundred of 400 children were randomized to receive atropine 1% in 1 eye only in this institutional study. Children were followed up with cycloplegic autorefraction every 4 months over 2 years. Children whose myopia progressed by more than 0.5 diopter (D) in the atropine-treated eye at 1 year were classified as being progressors.
  
  
  RESULTS
  Among the 182 children still in the study at 1 year, 22 (12.1%) were classified as progressors. Univariate analysis suggested these children tended to be younger (8.5 ± 1.4 years vs 9.3 ± 1.5 years; P = .023), to have higher myopic spherical equivalent (SE) at baseline (-3.6 ± 1.3 D vs -2.8 ± 1.4 D; P = .015), and to have 2 myopic parents (77.3% vs 48.1%; P = .012). In nonprogressors, the myopia progression at 1 year was less in the atropine-treated eyes compared with the untreated fellow eye (+0.16 ± 0.37 D vs -0.73 ± 0.48 D; P < .001), but in progressors, progression was more similar between eyes (-0.92 ± 0.31 D vs -1.06 ± 0.44 D; P = .363). Regression analysis showed that the risk of being a progressor was 40% lower with each year of increased age, 43% lower for every 1.0 D less in myopia at baseline, and 59% lower for every 1.0 D less in myopic change in the untreated eyes over the first year.
  
  
  CONCLUSIONS
  Doctors and parents need to be aware that there is a small group of children (younger, with higher myopia, and greater tendency of myopic progression) who may still progress while receiving atropine treatment.
authors: Singapore National Eye Center, Singapore.
authors: Kai-Lyn
authors: KL
authors: Loh
authors: Singapore Clinical Research Institute, Singapore; Center for Quantitative Medicine, Duke-National University of Singapore Graduate Medical School, Singapore.
authors: Qingshu
authors: Q
authors: Lu
authors: Singapore National Eye Center, Singapore; Singapore Eye Research Institute, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Donald
authors: D
authors: Tan
authors: Singapore National Eye Center, Singapore; Singapore Eye Research Institute, Singapore. Electronic address: wla_chia@yahoo.com.
authors: Audrey
authors: A
authors: Chia
mesh_terms: D000065:Accommodation, Ocular / Q000187:drug effects; D000287:Administration, Topical; D001285:Atropine / Q000008:administration & dosage*; D002648:Child; D015331:Cohort Studies; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D009216:Myopia / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D009883:Ophthalmic Solutions; D011680:Pupil / Q000187:drug effects; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D001285:Atropine