Purpose: To evaluate the efficacy and safety of atropine 0.01% in slowing myopia progression in European paediatric patients. Methods: Retrospective, medical records review study. Medical charts of paediatric patients with a myopia progression > 0.5 D/year treated with atropine 0.01% for at least 1 year were included. Patients receive a complete ophthalmic examination before and 12 months after initiation of atropine treatment. A group of myopic untreated children serves as a control group. The rate of myopia progression at baseline and 12 months after treatment with atropine was evaluated. The rate of myopia progression in treated and untreated patients was also compared. Adverse events were recorded. Results: Medical records of 52 treated and 50 control subjects were analysed. In the atropine group, the mean rate of myopia progression after 12 months of treatment (À0.54 AE 0.61 D) was significantly slower compared with the baseline progression (À1.20 AE 0.64 D; p < 0.0001) and to the progression in the control group (À1.09 AE 0.64; p < 0.0001). The responders patients were 41/52 (79%), whereas 11/52 patients (21%) showed a progression > 0.50 D despite treatment. The only adverse event was temporary photophobia in five patients (9.6%), severe adverse events were not reported, and none of the patients discontinued the treatment. Conclusion: Low-dose atropine significantly slowed the rate of myopia progression in European paediatric patients with a favourable safety profile.

Purpose : The identification of healthy subjects more susceptible to develop postsurgical ocular surface symptoms is still an unmet need. We performed this study to build a new Ocular Surface Frailty Index (OSFI) and to assess its predictive value for dry eye (DED) symptoms onset after cataract surgery. Design : Single-centre, observational, longitudinal study. Participants : We screened 405 consecutive patients scheduled for phacoemulsification for age-related cataract. 284 eyes of 284 patients without preoperative DED symptoms who underwent uneventful cataract surgery were included in the analysis. Methods : Borrowing a concept from geriatric surgery and following a previously validated procedure, we built an OSFI. Starting from a preliminary list of 19 potential items, the final OSFI, including 10 "deficits in ocular surface health and/or factors potentially able to affect it", was developed by a stepwise approach. Pre-operative OSFI was calculated for each patient and diagnostic tests for DED were performed (following the TFOS DEWS II recommendations) at the screening visit and 1 week (V1), 1 month (V2), and 3 months (V3) after surgery. We evaluated OSFI predictivity for the presence of DED symptoms at V2 AND/OR V3. Main Outcome Measures : The rate of ocular surface symptoms at V2 AND/OR V3. Results : Our patients' OSFI score ranged from 0 to 0.666, with a median value of 0.200 (0.133-0.266). The percentage of patients with post-surgical ocular surface symptoms was 17%. Using an OSFI cut-off of 0.300, we identified a small group (19% of the asymptomatic subjects) of patients with frail ocular surfaces, who had a significantly higher risk to develop post-surgical DED symptoms (50.0% vs 9.6%; P<0.001, χ2 test). Logistic regression analysis showed that OSFI≥0.3 (but not age, gender or any pre-operative sign) was a good predictor of ocular surface symptoms onset (odds ratio (OR) =9.45; 95%CI (4.74-18.82). Regression was still significant when performed on 200 bootstrapped samples. Conclusions : The OSFI can be easily and quickly calculated using non-invasive and low-tech procedures and it showed to be predictive of post-operative ocular surface symptoms onset. This novel tool might allow cataract surgeons to perform a useful preoperative personalized risk assessment.

No abstract