Risk factors for progressive myopia in the atropine therapy for myopia study.

Abstract

PURPOSE:

To investigate variables associated with myopic progression despite treatment in the Atropine in the Treatment of Myopia Study.

DESIGN:

Retrospective cohort study.

METHODS:

Two hundred of 400 children were randomized to receive atropine 1% in 1 eye only in this institutional study. Children were followed up with cycloplegic autorefraction every 4 months over 2 years. Children whose myopia progressed by more than 0.5 diopter (D) in the atropine-treated eye at 1 year were classified as being progressors.

RESULTS:

Among the 182 children still in the study at 1 year, 22 (12.1%) were classified as progressors. Univariate analysis suggested these children tended to be younger (8.5 ± 1.4 years vs 9.3 ± 1.5 years; P = .023), to have higher myopic spherical equivalent (SE) at baseline (-3.6 ± 1.3 D vs -2.8 ± 1.4 D; P = .015), and to have 2 myopic parents (77.3% vs 48.1%; P = .012). In nonprogressors, the myopia progression at 1 year was less in the atropine-treated eyes compared with the untreated fellow eye (+0.16 ± 0.37 D vs -0.73 ± 0.48 D; P < .001), but in progressors, progression was more similar between eyes (-0.92 ± 0.31 D vs -1.06 ± 0.44 D; P = .363). Regression analysis showed that the risk of being a progressor was 40% lower with each year of increased age, 43% lower for every 1.0 D less in myopia at baseline, and 59% lower for every 1.0 D less in myopic change in the untreated eyes over the first year.

CONCLUSIONS:

Doctors and parents need to be aware that there is a small group of children (younger, with higher myopia, and greater tendency of myopic progression) who may still progress while receiving atropine treatment.

• Authors: Kai-Lyn Loh, Qingshu Lu, Donald Tan, Audrey Chia
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 159 Issue 5 Pg. 945-9 (May 2015) ISSN: 1879-1891 [Electronic] United States
• PMID: 25640408 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Mydriatics
• Ophthalmic Solutions
• Atropine

Topics

• Accommodation, Ocular (drug effects)
• Administration, Topical
• Atropine (administration & dosage)
• Child
• Cohort Studies
• Disease Progression
• Double-Blind Method
• Female
• Humans
• Male
• Mydriatics (administration & dosage)
• Myopia (diagnosis, drug therapy, physiopathology)
• Ophthalmic Solutions
• Pupil (drug effects)
• Refraction, Ocular (physiology)
• Retrospective Studies
• Risk Factors
• Surveys and Questionnaires
• Visual Acuity (physiology)