Effects of Atropine Treatment on Choroidal Thickness in Myopic Children

Abstract

Purpose To examine the changes in choroidal thickness (ChT) after 6 months of 1% or 0.01% atropine treatment and the independent factors associated with eye elongation. Methods A total of 207 myopic children aged 6 to 12 years were recruited and randomly assigned to groups A and B in a ratio of 1:1. Participants in group A received 1% atropine once a day for 1 week, and then once a week for 23 weeks. Participants in group B received 0.01% atropine once a day for 6 months. ChT and internal axial length (IAL) were measured at baseline, 1 week, 3 months, and 6 months. Results In group A, the ChT significantly increased after a 1-week loading dose of 1% atropine (26 ± 14 µm; P < 0.001) and the magnitude of increase stabilized throughout the following weekly treatment. The internal axial length did not significantly change at the 6-month visit (−0.01 ± 0.11 mm; P = 0.74). In contrast, a decreased ChT (−5 ± 17 µm; P < 0.001) and pronounced eye elongation (0.19 ± 0.12 mm; P < 0.001) were observed in group B after 6 months. Multivariable regression analysis showed that less increase in ChT at the 1-week visit ( P = 0.03), younger age ( P < 0.001), and presence of peripapillary atrophy ( P = 0.001) were significantly associated with greater internal axial length increase over 6 months in group A. Conclusions One percent atropine could increase the ChT, whereas 0.01% atropine caused a decrease in ChT after 6 months of treatment. For participants receiving 1% atropine, the short-term increase in ChT was negatively associated with long-term eye elongation. Younger age and the presence of peripapillary atrophy were found to be risk factors for greater eye elongation.

Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children

“…The thickening response of the choroid was rapid and significant within only 1 month or even 1 week of atropine treatment (1%, 0.3% and 0.01% atropine) and became slower and insignificant after that [61][62][63]. In the present study, the thickening of subfoveal ChT in the atropine group was 5.20 ± 10.86 lm at 1-month visit, which is comparable to the aforementioned study.…”

The Role of Atropine in Preventing Myopia Progression: An Update

“…Furthermore, an in vitro study on human cells proved that atropine was able to decrease in vitro ECM biosynthesis in the choroid, with local fibroblasts improving scleral blood perfusion through the choroid, improving ECM perfusion and thus decreasing myopia progression [ 81 ]. Furthermore, atropine has been able to increase choroidal thickness in both healthy and myopic children and to block choroidal thinning associated with hyperopic defocus [ 82 , 83 , 84 , 85 ]. Future research could provide us with an exhaustive theoretical model that would explain in detail the biological pathways and effectors that determine the observed efficacy of this drug.…”

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

“…A week of twice daily administration of 1% atropine ophthalmic gel led to a significant increase in subfoveal and parafoveal CT 18 . Two additional studies investigating the effect of 1% atropine have found similar findings of increased CT 19,20 . The study by Jiang et al .…”