Differential Impact of 0.01% and 0.05% Atropine Eyedrops on Ocular Surface in Young Adults

Abstract

Purpose To evaluate the effect of low-concentration (0.01% and 0.05%) atropine eyedrops on ocular surface characteristics in young adults. Methods Twenty-six myopic students aged 18 to 30 years were randomly assigned to receive either 0.01% or 0.05% atropine once nightly for 14 days, followed by cessation, with a ≥14-day interval between each administration. Assessments were conducted one, two, seven, and 14 days after using atropine with corresponding timepoints after atropine cessation. Tear meniscus height and first and average noninvasive keratograph tear film breakup time (NIKBUT-first, NIKBUT-average) were measured using Keratograph 5M, whereas the objective scatter index (OSI) was measured by OQAS II devices; the ocular surface disease index (OSDI) score was also obtained. Results The mean OSI peaked after two days of administration of 0.05% atropine ( β = 0.51, P = 0.001), accompanied by significant decreases in NIKBUT-first ( β = −7.73, P < 0.001) and NIKBUT-average ( β = −8.10, P < 0.001); the OSDI peaked after 14 days ( β = 15.41, P < 0.001). The above parameters returned to baseline one week after atropine discontinuation (all P > 0.05). NIKBUT-first and NIKBUT-average reached their lowest points after 14 days of 0.01% atropine administration (NIKBUT-first: β = −4.46, P = 0.005; NIKBUT-average: β = −4.42, P = 0.001), but those significant changes were diminished once atropine treatment stopped. Conclusions Young adult myopes experienced a significant but temporary impact on the ocular surface with 0.05% atropine administration, whereas 0.01% atropine had a minimal effect. Translational Relevance The investigation of the ocular surface effects of different concentrations of atropine may inform evidence-based clinical decisions regarding myopia control in young adults.

Efficacy and Safety of 0.03% Atropine Eye Drops in Controlling Myopia Progression: A One-Year Prospective Clinical Study

“…A retrospective analysis conducted in Germany by Kaymak et al [ 38 ] revealed that nearly 17.0% of children treated with 0.01% atropine reported side effects such as burning eyes following drop instillation, pupil dilatation, photophobia or eye redness. Another study evaluating the impact of 0.01% and 0.05% atropine eye drops on the ocular surface in young myopic adults concluded that 0.05% atropine has a significant yet temporary effect on the tear film and 0.01% atropine has minimal impact on the ocular surface [ 13 ]. In a study by Medghalchi et al [ 39 ], four patients (16%) in the 0.1% atropine group experienced headaches compared to none in 0.01% group ( p = 0.032), while 11 patients (44%) in the 0.1% atropine group had photophobia compared to four patients (20%) in the 0.01% atropine group ( p = 0.001); additionally, 11 patients (44%) in the 0.1% atropine group experienced blurred vision, while none in the 0.01% atropine group had this side effect ( p < 0.001).…”

“…Among the strategies available for managing myopia progression, atropine eye drops are widely regarded as one of the most effective interventions, with numerous studies demonstrating their ability to effectively and safely manage myopia progression in children, both those with premyopia and those already myopic [ 7 , 8 , 9 , 10 , 11 ]. However, it is important to note that the efficacy of atropine is concentration-dependent, with higher concentrations associated with increased risk of adverse events and rebound effects [ 11 , 12 , 13 ]. Post cessation of atropine eye drops, myopia tends to progress at a faster rate compared to its progression during treatment with atropine eye drops [ 14 , 15 ].…”