Risk factors for rapid axial length elongation with low concentration atropine for myopia control

Abstract

Three hundred and twenty-eight myopic children, randomized to use either 0.01% (N=166) or 0.02% (N=162) atropine were enrolled in this study. Gender, age, body mass index(BMI), parental myopia status, atropine concentration used, pupil diameter, amplitude of accommodation, spherical equivalent refractive error (SER), anterior chamber depth (ACD) and axial length (AL) were collected at baseline and 1 year after using atropine. Rapid AL elongation was defined as >0.36 mm growth per year. Univariate analyses showed that children with rapid AL elongation tend to be younger, have a smaller BMI, use of 0.01% atropine, narrow ACD, lower SER, shorter AL, smaller change in pupil diameter between 1 year and baseline (all P < 0.05). Multivariate regression analyses confirmed that rapid AL elongation was associated with children that were younger at baseline (P < 0.0001), use of 0.01% atropine (P = 0.04), a shorter baseline AL (P = 0.03) and a smaller change in pupil diameter between 1 year and baseline (P = 0.04). Younger children with shorter AL at baseline, less change in their pupil diameter with atropine treatment and using the lower of the two atropine concentrations may undergo rapid AL elongation over a 12 months myopia control treatment period.

Orthokeratology Lenses Versus Administration of 0.01% Atropine Eye Drops for Axial Length Elongation in Children With Myopic Anisometropia

“…Some studies 12,13,37 found that low-dose atropine controlled myopia progression and AL elongation synchronously. However, in the ATOM2 study, 41 the changes in AL and changes in SER were not synchronous, whereas the degree of myopia was stable, and AL continued to increase between 8 and 24 months after using 0.01% atropine. In this study, after 1 year of 0.01% atropine treatment, the changes in SER corresponded to the changes in AL.…”

Combined 0.01% atropine with orthokeratology in childhood myopia control (AOK) study: A 2-year randomized clinical trial

“…Individual slope and intercept were included as random effects and an unstructured covariance matrix was used to control inter-subject variation. It was found that baseline age and SER were associated with axial elongation in children who underwent orthoky [14,36,37] or treatment of low-concentration atropine [38,39]. Thus, baseline age and SER were included as covariates.…”

Combination of orthokeratology lens with 0.01% atropine in slowing axial elongation in children with myopia: a randomized double-blinded clinical trial

“…Increase in PD is one of the most important side effects of low-dose atropine eye drops [5][6][7]15]. Our study found that 0.01% atropine had a minimal impact on PD in the combination groups.…”

“…The details of the examination method for the observation items have been published elsewhere and are briefly described here [7,15]. AL, corneal power, and anterior chamber depth (ACD) were evaluated using a non-contact partial coherence interferometer (IOLMaster; Carl Zeiss Meditec AG, Germany).…”

“…Many studies have shown that some concentrations of low concentration atropine can effectively control the progression of myopia [5][6][7]13]. Conversely, it has been observed that the efficacy of the OK lens and low concentrations atropine was associated with many factors [14,15], and that OK lens and low concentration atropine failed to control myopia progression in a small number of children.…”