Short-term effects of atropine combined with orthokeratology (ACO) on choroidal thickness

Zhao, Wenchen; Li, Zhouyue; Hu, Yin; Jiang, Jinyun; Wen, Lin; Cui, Dongmei; Chen, Wei-Yin; Yang, Xiao

doi:10.1016/j.clae.2020.06.006

Cited by 36 publications

(57 citation statements)

References 42 publications

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“…A slight increase in ChT was observed in participants receiving 0.01% atropine for 3 months, which was consistent with other studies (5-6 μm). 29,31 Yet, an opposite change in ChT was observed at the 6-month visit (−5 ± 17 μm). It could be that the effect of 0.01% atropine on choroid attenuated after the first 3 months of use and ChT decreased as AL elongates 25 during the second 3 months.…”

Section: The Changes In Chtmentioning

confidence: 90%

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Effects of Atropine Treatment on Choroidal Thickness in Myopic Children

Shi

Yao

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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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.

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Section: The Changes In Chtmentioning

confidence: 90%

“… 27 Choroidal thickening was also observed in healthy children treated with 1% atropine for 1 week 28 and in myopic children administered with 0.01% atropine for less than 8 weeks. 29 – 31 However, the long-term effects of atropine on ChT in myopic children and its association with eye elongation remain unknown.…”

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confidence: 99%

Effects of Atropine Treatment on Choroidal Thickness in Myopic Children

Shi

Yao

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…Based on previous studies in humans and animals, both 1% and 0.01% atropine have been found to increase choroidal thickness and inhibit choroidal thinning induced by hyperopic defocus. [16][17][18][19] Therefore, the choroid may be a potential action site for atropine, which needs to be confirmed in a larger population of myopic children. On the other hand, the dimensions and optics of the lens and cornea are closely associated with spherical equivalent and axial length; thus, changes of biometric changes in these two ocular components may relate to the myopia inhibition by atropine, but this is poorly understood.…”

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confidence: 99%

Comparisons of atropine versus cyclopentolate cycloplegia in myopic children

Shi

et al. 2021

Clinical and Experimental Optometry

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Clinical relevance: In clinical practice, 1% atropine and 1% cyclopentolate are used as cycloplegia agents to diagnose refractive error. The influence of 1% atropine on ocular biometry is obscure, and the impact of 1% cyclopentolate remains controversial. Background: This study aims to compare the effects of atropine versus cyclopentolate cycloplegia on ocular biometry in myopic children and to determine the sites of action for atropine. Methods: A total of 207 myopic children aged 6-12-years were included in the analysis. All participants underwent comprehensive eye examinations before and after cyclopentolate cycloplegia, after which they were randomly assigned into two groups, A and B, in a ratio of 1:1, to receive 1% or 0.01% atropine, respectively. The treatment was administered once every night for a week. Participants were re-examined one week later. Results: Cyclopentolate cycloplegia caused a decrease in choroidal thickness (−3 ± 9 μm, p = 0.001), elongation of axial length (9 ± 16 μm, p < 0.001), loss of lens power (−0.14 ± 0.37 dioptre, p < 0.001), and a hyperopic shift (0.14 ± 0.22 dioptre, p < 0.001) in both groups. However, ocular biometry showed different changes after one-week use of 1% or 0.01% atropine (all p < 0.001). In Group A, choroid thickening (24 ± 13 μm, p < 0.001) and reduced axial length (−30 ± 27 μm, p < 0.001) were observed after atropine cycloplegia, with greater changes in lens power (0.50 ± 0.37 dioptre, p < 0.001) and spherical equivalent (0.52 ± 0.23 dioptre, p < 0.001). Group B showed a slight increase in choroidal thickness following one-week use of 0.01% atropine (6 ± 9 μm, p < 0.001), but other biometric measures showed no significant changes. Conclusion:Cyclopentolate and atropine cycloplegia have different effects on ocular biometry. Both 1% cyclopentolate cycloplegia and 0.01% atropine resulted in choroidal thickening, indicating that the choroid may be a site of action for atropine.

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“…In contrast, the impact of low concentration atropine (0.01%) on choroidal thickness remains controversial. Studies with positive results revealed a much less choroidal thickening, e.g., 6 µm after 1 hour [42] and 5 µm after 1 month use of 0.01%A [43]. Since some children who experience fast AL growth will exhibit a thinning of the choroid [23], it is not surprising that we found a slightly thinner choroid after 0.01%A use for 6 months.…”

Section: Discussionmentioning

confidence: 49%

The Effect of 0.01% Atropine Eye Drops Combined with Auricular Acupoint Stimulation on Myopia Progression and Choroidal Thickness: The Preliminary Results from a Randomized Controlled Trial

Kong¹,

Zhao²,

Chen³

et al. 2020

Preprint

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Background: Use of 0.01% atropine eye drops (0.01%A) is one of the most common treatments for myopia control for children in Asia. Auricular acupoint stimulation (AAS) was reported to enhance the effect of higher-concentration atropine (0.25%, 0.125%) on myopia control. This study was designed to compare the effect of 0.01%A combined with AAS and 0.01%A alone on myopia progression and choroidal thickness in children.Methods: A total of 104 children were stratified by age and randomly assigned at 1:1 to receive 0.01%A or 0.01%A+AAS treatment for 6 months. Repeated measurements of cycloplegic spherical equivalent (SE) autorefraction, axial length (AL), and choroidal thickness were performed at baseline, 1 month, 3 months and 6 months.Results: The adjusted mean SE change over the 6 months was −0.38 ± 0.04 D in the 0.01%A group (n = 50) and −0.25 ± 0.04 D in the 0.01%A+AAS group (n = 50), demonstrating a significant between-group difference (P = 0.02). There was no statistically significant difference in the change of AL or choroidal thickness between the two groups (both P > 0.05).Conclusion: Compared with 0.01%A monotherapy, AAS as adjunctive treatment slowed myopic progression in Chinese children by a small, statistically amount during this 6-month observation. Future follow-up study is needed to verify its effects on axial elongation or choroidal thickness.Trial registration: Trial registration: Chinese Clinical Trial Registry, ChiCTR1900021316. Registered 13 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35435

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Short-term effects of atropine combined with orthokeratology (ACO) on choroidal thickness

Cited by 36 publications

References 42 publications

Effects of Atropine Treatment on Choroidal Thickness in Myopic Children

Effects of Atropine Treatment on Choroidal Thickness in Myopic Children

Comparisons of atropine versus cyclopentolate cycloplegia in myopic children

The Effect of 0.01% Atropine Eye Drops Combined with Auricular Acupoint Stimulation on Myopia Progression and Choroidal Thickness: The Preliminary Results from a Randomized Controlled Trial

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