Therapeutic effect of atropine 1% in children with low myopia

Su, Yi; Huang, Yurong; Yu, Shi-Zhi; Chen, Xi-Jia; Hong, Ye; Zeng, Xiaoli

doi:10.1016/j.jaapos.2015.04.006

Cited by 66 publications

(75 citation statements)

References 28 publications

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“…; Yi et al. ). However, the recent use of a lower dose formulation of atropine at 0.01% has gained favour due to increased long‐term efficacies, less rebound deterioration and reduced systemic adverse effects (Chia et al.…”

Section: Discussionmentioning

confidence: 97%

The penetration and distribution of topical atropine in animal ocular tissues

Wang

Syn

et al. 2018

Acta Ophthalmologica

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Purpose: To conduct a multi-tissue investigation on the penetration and distribution of topical atropine in myopia treatment, and determine if atropine is detectable in the untreated contralateral eye after uniocular instillation. Methods: Nine mature New Zealand white rabbits were evenly divided into three groups. Each group was killed at 5, 24 and 72 hr, respectively, following uniocular instillation of 0.05 ml of 1% atropine. Tissues were sampled after enucleation: conjunctiva, sclera, cornea, iris, ciliary body, lens, retina, aqueous, and vitreous humors. The assay for atropine was performed using liquid chromatography-mass spectrometry (LC-MS), and molecular tissue distribution was illustrated using matrix-assisted laser desorption ionization-imaging mass spectrometry (MALDI-IMS) via an independent experiment on murine eyes. Results: At 5 hr, the highest (mean AE SEM) concentration of atropine was detected in the conjunctiva (19.05 AE 5.57 ng/mg, p < 0.05) with a concentration gradient established anteriorly to posteriorly, as supported by MALDI-IMS. At 24 hr, preferential binding of atropine to posterior ocular tissues occurred, demonstrating a reversal of the initial concentration gradient. Atropine has good ocular bioavailability with concentrations of two magnitudes higher than its binding affinity in most tissues at 3 days. Crossing-over of atropine to the untreated eye occurred within 5 hr post-administration. Conclusion: Both transcorneal and transconjunctival-scleral routes are key in atropine absorption. Posterior ocular tissues could be important sites of action by atropine in myopic reduction. In uniocular atropine trials, cross-over effects on the placebo eye should be adjusted to enhance results reliability. Combining the use of LC-MS and MALDI-IMS can be a viable approach in the study of the ocular pharmacokinetics of atropine.

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Section: Discussionmentioning

confidence: 97%

The penetration and distribution of topical atropine in animal ocular tissues

Wang

Syn

et al. 2018

Acta Ophthalmologica

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“…[22–24] In the present study, the myopic progression, as measured by SE, and AL elongation, as measured by AL, were significantly reduced for participants in the intervention group than for those in the control group. These results indicate the promising efficacy of 0.5% ATE for myopia control in participants with LM.…”

Section: Discussionmentioning

confidence: 50%

“…[23] Another study focused on the use of high-concentration ATE (1%) in the treatment of Chinese children with LM, and found that it could either decrease the degree of LM or slow the progression of axial ocular elongation. [24] …”

Section: Discussionmentioning

confidence: 99%

Atropine 0.5% eyedrops for the treatment of children with low myopia

2017

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Background:This study aimed to assess the efficacy and safety of atropine 0.5% eyedrops (ATE) for the treatment of children with low myopia (LM).Methods:In this study, a total of 126 children with LM were randomly divided into an intervention group (administered 0.5% ATE) and a control group (administered a placebo), with 63 children in each group. The outcome measurements were changes in the spherical equivalent (SE), and axial length (AL), as well as adverse events (AEs).Results:Compared with placebo, administration of 0.5% ATE led to less progression in LM, as measured by SE, and less increase in AL (P < .01). In addition, no serious AEs occurred in both the groups.Conclusion:About 0.5% ATE was efficacious and safe for controlling myopia in children with LM.

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“…Atropine eye drops, along with orthokeratology and multifocal contact lenses, are the most effective treatments for slowing myopia progression. Nightly instillation of one drop of 1% atropine effectively halts the progressive increase in myopic refractive error and eye elongation relative to untreated eyes . However, adverse side effects including mydriasis, cycloplegia and accelerated progression on cessation (rebound), have limited the clinical use of 1% atropine.…”

mentioning

confidence: 99%

“…Nightly instillation of one drop of 1% atropine effectively halts the progressive increase in myopic refractive error and eye elongation relative to untreated eyes. 2 However, adverse side effects including mydriasis, cycloplegia and accelerated progression on cessation (rebound), have limited the clinical use of 1% atropine. Consequently, interest has shifted to the use of much lower concentrations, which also appear to reduce myopia progression, although in a dose-dependent manner.…”

mentioning

confidence: 99%