Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study

Abstract Purpose Based on findings of the Asian low-concentration atropine for myopia progression study, a concentration of 0.05% has been proposed as a good compromise between safety and efficacy for myopia control. However, no data on side effects have been published so far in Caucasian children receiving this dose. Methods Prior to commencement of bilateral atropine treatment with 0.05% atropine, 19 myopic children aged 5 to 15 years were treated in only one eye at bedtime leaving the other eye as a control. Pupil size, accommodation amplitude and near visual acuity were measured at 10:00 a.m. the next day and compared to the untreated contralateral control eye. The results were then compared to a cohort of 18 children whose treatment with 0.01% atropine commenced in a similar fashion. Results Twelve children (63%) reported visual impairment or reading difficulties. Anisocoria was 2.9 ± 1.1 mm. In comparison, 0.01% atropine led to a significantly less anisocoria of 0.8 ± 0.7 mm (p < 0.0001). Accommodation was decreased by − 4.2 ± 3.8 D in 0.05% atropine treated eyes, whereas 0.01% atropine induced hypoaccommodation of − 0.05 ± 2.5 D (p < 0.01). Near visual acuity was not significantly reduced in eyes treated with 0.05% atropine compared to 0.01% atropine (p = 0.26). Conclusion Compared to 0.01%, our data indicate stronger more relevant side effects of 0.05% topical atropine in young Caucasian children with progressive myopia as recently reported in Asian children, potentially compromising acceptance and compliance.

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Myopiekontrolle: aktuelle Strategien

Optometry & Contact Lenses ◽

10.54352/dozv.ofnt2569 ◽

2021 ◽

Vol 1 (5) ◽

pp. 148-155

Keyword(s):

Contact Lenses ◽

Long Term Effects ◽

Soft Contact ◽

Myopia Progression ◽

Soft Contact Lenses ◽

Slowing Down ◽

The Future ◽

Progressive Myopia ◽

The Individual ◽

Myopia Control

Purpose. The prevalence of myopia is increasing worldwide and its long-term effects can have major impacts on eye health. Paediatric onset of myopia leads to a higher risk for developing high levels of myopia in adulthood. Slowing down or stopping myopia progression is an important task for the future. Material and Methods. Based on a literature review, the latest developments in the field of myopia control for children were summarized. The current study situation for orthokeratology, soft contact lenses, atropine therapy and spectacle lenses for the management of myopia is discussed in detail. Results. Results on the safety and effectiveness of orthokeratology and modified soft contact lenses are exceedingly consistent. Soft multifocal contact lenses, as well as newer spectacle lenses, recently received regulatory approval for myopia control. Studies on the administration of atropine recommend a dosage of 0.01 - 0.05 %. All methods slow down myopia progression and decrease axial length growth of the eye. Side effects, adverse events or discontinuation of treatment only occur in the rarest of cases. Orthokeratology and atropine continue to deliver the best results. Conclusion. From today’s perspective, carrying out myopia control can be recommended with great certainty. The choice of method depends on the individual requirements of each patient, with all methods offering success in reducing myopia progression. In the future, even more advanced contact lens geometries, more precise atropine dosages or improved optics of spectacle lenses will further increase the success of the treatment. Keywords. Progressive myopia, myopia control, children, contact lenses, atropine, spectacle lenses

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Orthokeratology lenses and myopia control

The Eye ◽

10.33791/2222-4408-2019-2-13-20 ◽

2019 ◽

Vol 126 (2019-2) ◽

pp. 13-20

Author(s):

Pyotr Nagorsky ◽

Nikolai Kikhtenko ◽

Vera Milyukhina

Keyword(s):

Axial Length ◽

Growth Dynamics ◽

Control Group ◽

Myopia Progression ◽

Eye Growth ◽

Vision Correction ◽

Uncorrected Visual Acuity ◽

Progressive Myopia ◽

Observation Period ◽

Myopia Control

Purpose: To estimate the stabilizing effect of orthokeratology lenses (ortho-K, OK-lenses) on myopia progression by evaluating axial eye growth dynamics and clinical refraction. Material and methods. Ortho-K group consisted of 68 children (135 eyes) aged 7–17 years (mean age 12.2) with progressive myopia (initially -0.75–6.75 D). Observation period varied from 7 to 30 months (mean period 11.68±4.39). All patients used OK-lenses for overnight wear. The control group consisted of 90 patients (180 eyes) with myopia who were prescribed single vision spectacles for vision correction. Comparative analysis was performed for clinical refraction parameters as well as for axial length (AL). The data was obtained with the use of IOL-Master optical biometer (“Carl Zeiss”). Results. The parameters were stable in patients of ortho-K group: axial length, subjective and objective clinical refraction, the required power of corrective lenses. However, the parameters changed significantly in the control group during the observation period: uncorrected visual acuity (UCVA) decreased, the required power of corrective lenses increased, the indices of objective clinical refraction strengthened, annual gradient of progression (AGP) amounted to 0.26±0.19 and 0.16±0,39 mm in patients with low and moderate myopia, respectively. Conclusion. The use of OK-lenses ensures a significant deceleration of myopia progression in children. The results obtained suggest a wider use of ortho-K among pediatric ophthalmologists in their clinical practice as it is an effective preventive and therapeutic method for patients with progressive myopia.

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CONTROLLING MYOPIA PROGRESSION IN CHILDREN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1332 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Neelam Verma

Keyword(s):

Systematic Review ◽

Contact Lenses ◽

Treatment Options ◽

East Asian ◽

Asian Countries ◽

Myopia Progression ◽

The Us ◽

Progressive Myopia ◽

Pharmaceutical Agents ◽

Myopia Control

Main aim of this article was a systematic review on causes and management of Myopia progression in children. Myopia is a general disorder, affecting just about one-third of the US population and over 90% of the population in some East Asian countries. Elevated amounts of myopia are connected with a bigger risk of sight-threatening troubles, such as retinal detachment, choroidal degeneration, cataracts and glaucoma. Slowing the progression of myopia could potentially advantage millions of children in the India. Few approaches used for myopia organize have proven to be useful. Treatment options such as undercorrection of myopia, gas permeable contact lenses, and bifocal or multifocal spectacles have all been proven to be ineffective for myopia control, although one recent randomized clinical trial using executive top bifocal spectacles on children with progressive myopia has shown to decrease the progression to nearly half of the control subjects. The most effective methods are the use of orthokeratology contact lenses, soft bifocal contact lenses, and pharmaceutical agents such as atropine, timolol or pirenzepine. Keyword: Myopia progression, pharmaceutical agents, lenses, treatment.

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Additive effect of atropine eye drops and short-term retinal defocus on choroidal thickness in children with myopia

Scientific Reports ◽

10.1038/s41598-020-75342-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Samuel T.-H. Chiang ◽

Philip R. K. Turnbull ◽

John R. Phillips

Keyword(s):

Eye Drops ◽

Additive Effects ◽

Short Term ◽

Myopia Progression ◽

Eye Growth ◽

Slow Progression ◽

Before And After ◽

Atropine Treatment ◽

Optical Defocus ◽

Myopia Control

Abstract Atropine eye drops and myopic retinal defocus each slow progression of myopia (short-sight). They also cause thickening of the choroid, and it has been suggested that the thickening is a precursor for reduced eye growth and slowed myopia progression. We investigated whether choroidal thickening due to optical defocus would add to thickening due to atropine when both were applied simultaneously. Addition would suggest that combining the two clinical treatments may improve efficacy of myopia control. We studied 20 children receiving 0.3% atropine daily for myopia control, over a period of 6 months. We imposed short periods of retinal defocus (1 h of myopic or hyperopic defocus (± 2.00D)) both before, and after 1 week and 3 and 6 months of atropine treatment. Prior to atropine, myopic or hyperopic defocus caused significantly thicker or thinner choroids respectively (± 12 µm, p < 0.001). After one week of atropine alone, thickness had increased (+ 21 µm; SD 17 µm; p < 0.001), and it increased further (by + 13 µm; SD 6 µm; p < 0.001) when exposed to myopic defocus. Atropine abolished choroidal thinning in response to hyperopic defocus. These effects remained the same after 3 and 6 months of atropine treatment. Our results show that additive effects of atropine and optical defocus are present at the level of the choroid, and suggest that combining optical and pharmaceutical treatments is likely to enhance efficacy of clinical myopia control.

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Use of Atropine to Slow the Progression of Myopia: A Literature Review and Guidelines for Clinical Use

Vision Development & Rehabilitation ◽

10.31707/vdr2018.4.1.p12 ◽

2018 ◽

pp. 12-28

Keyword(s):

Side Effects ◽

Literature Review ◽

Meta Analysis ◽

Effective Drug ◽

Clinical Use ◽

Lower Side ◽

Myopia Progression ◽

Ocular Side ◽

Cumulative Data ◽

Atropine Treatment

Atropine 1% and various lower concentrations of atropine (0.5-0.01%) have been used to slow the progression of myopia. Cumulative data and meta-analysis from a number of studies have demonstrated that the most effective method for slowing the progression of myopia is atropine 1% instilled daily ( progression is slowed by almost 80%). Atropine’s side effects of mydriasis and cycloplegia have kept it from being prescribed more frequently. Recent studies have demonstrated that lower concentrations of atropine 0.025% to 0.01% are effective with significantly lower side effects. Discontinuing atropine treatment has displayed a rebound of myopia progression with higher amounts of rebound associated with higher atropine concentrations. Ocular side effects of atropine can be effectively managed with photochromic progressive lenses. In summary, atropine is not only safe, but it is also an effective drug to slow the progression of myopia.

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The Combined Effect of Low-dose Atropine with Orthokeratology in Pediatric Myopia Control: Review of the Current Treatment Status for Myopia

Journal of Clinical Medicine ◽

10.3390/jcm9082371 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2371

Author(s):

José-María Sánchez-González ◽

Concepción De-Hita-Cantalejo ◽

María-José Baustita-Llamas ◽

María Carmen Sánchez-González ◽

Raúl Capote-Puente

Keyword(s):

Low Dose ◽

Search Strategy ◽

Web Of Science ◽

Scientific Literature ◽

Current Treatment ◽

Health Concern ◽

Myopia Progression ◽

Atropine Treatment ◽

Myopia Control

Pediatric myopia has become a major international public health concern. The prevalence of myopia has undergone a significant increase worldwide. The purpose of this review of the current literature was to evaluate the peer-reviewed scientific literature on the efficacy and safety of low-dose atropine treatment combined with overnight orthokeratology for myopia control. A search was conducted in Pubmed and Web of Science with the following search strategy: (atropine OR low-dose atropine OR 0.01% atropine) AND (orthokeratology OR ortho-k) AND (myopia control OR myopia progression). All included studies improved myopia control by the synergistic effect of orthokeratology with low-dose atropine, compared with orthokeratology treatment alone. All studies included a short or medium follow-up period; therefore longer-term studies are necessary to validate these results.

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Multi-Factoral Mechanisms of Therapeutic Effect of Perifocal Spectacles (Perifocal-M) on Progressive Myopia in Children

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-4-433-438 ◽

2019 ◽

Vol 15 (4) ◽

pp. 433-438 ◽

Cited By ~ 2

Author(s):

R. A. Ibatulin ◽

O. V. Proskurina ◽

E. P. Tarutta

Keyword(s):

Regulatory Control ◽

Optical Methods ◽

Myopia Progression ◽

Detailed Review ◽

Eye Growth ◽

Progressive Myopia ◽

Near Work ◽

First Time ◽

Complex Influence ◽

Myopia Control

There is detailed review of multi-factoral mechanisms of spectacles with peripheral defocus influence in children with progressive myopia in this article. At present local retinal mechanisms of neuro-regulatory control of eye growth are most effective in prevention of myopia development and progression. Optical correction of relative peripheral hyperopia with following peripheral myopic defocus affects the biochemical cascade from retina to choroid and sclera, which constrains an eye growth. Optical methods of myopia control, including spectacles, widely used in native and foreign ophthalmology practice. Since 2011, in Russia Perifocal-M spectacles are using, said spectacles provides bigger functionality of influence on myopic eye comparing to foreign analogues. Construction features of said spectacle lens have a complex influence on different optic-physiological eye structures and each of said structures affects refractogenesis. Perifocal spectacles takes into account specific for myopic eye features of central and peripheral refraction along horizontal and vertical meridians. They have stronger refraction in horizontal, which allows to eliminate specific optical disbalance in myopic eye and to create optical balance in the eye. Perifocal-M lens construction with asymmetric horizontal progression allows to correct relative peripheral hyperopia, to create myopic defocus in horizontal and to affect relations between refraction of nasal and temporal halves of retina. The latter is due to the fact that optical influence starts earlier and has bigger effect on nasal half of retina relative to temporal. Perifocal spectacles are inducing positive spherical aberrations in the eye, increasing accommodation functions, supporting high binocular visual acuity, improving binocular interaction during near work, fighting against heteroforias. Thus, optical features of Perifocal-M spectacles for the first time creates conditions for versatile functional influence on main myopogenic factors simultaneously, it effectively stops myopia progression.

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Peripheral Refraction in Myopic Children with and without Atropine Usage

Journal of Ophthalmology ◽

10.1155/2020/4919154 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Han-Yin Sun ◽

Wei-Yang Lu ◽

Jhen-Yu You ◽

Hui-Ying Kuo

Keyword(s):

Chinese Children ◽

Spherical Equivalent ◽

Myopia Progression ◽

Prolate Shape ◽

Atropine Treatment ◽

Myopia Control

Purpose. To compare the patterns of relative peripheral refractions of myopic children who were currently on atropine treatment for myopia control and myopic children who did not use atropine. Methods. Chinese children (n = 209) aged 7 to 12 years participated in the study, 106 used atropine and 103 did not. Participants were also classified into three groups: emmetropes (SE: +0.50 to −0.50 D), low myopes (SE: −0.50 to −3.00 D), and moderate myopes (SE: −3.00 to −6.00 D). The central and peripheral refractions along the horizontal meridians (for both nasal and temporal fields) were measured in 10-degree steps to 30 degrees. Results. There were no statistically significant differences in spherical equivalent and astigmatism of the three refractive groups in either the nasal or temporal retina. The atropine group showed a significant relative myopia in the temporal 30° field in spherical equivalent compared to the emmetropic group (t49 = 3.36, P=0.02). In eyes with low myopia, the atropine group had significant relative myopia in the nasal 30° and temporal 30° fields (t118 = 2.59, P=0.01; t118 = 2.06, P=0.04), and it is also observed at 20° and 30° of the nasal field for the moderate myopic group (t36 = 2.37, P=0.02; t2.84 = 2.84, P=0.01). Conclusion. Significant differences in relative peripheral refraction were found between the atropine group and its controls. The findings suggested that the eyes that received atropine may have a less prolate shape and thus explain why using atropine is effective in controlling myopia progression.

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Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-86222-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yueyang Zhong ◽

Kai Wang ◽

Xiaoning Yu ◽

Xin Liu ◽

Ke Yao

Keyword(s):

Systematic Review ◽

Visual Acuity ◽

Meta Analysis ◽

Visual Quality ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Refractive Lens Exchange ◽

Extended Depth Of Focus ◽

Refractive Lens ◽

Near Visual Acuity

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

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Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute

European Journal of Ophthalmology ◽

10.1177/1120672121998960 ◽

2021 ◽

pp. 112067212199896

Author(s):

János Németh ◽

Beáta Tapasztó ◽

Wagih A Aclimandos ◽

Philippe Kestelyn ◽

Jost B Jonas ◽

...

Keyword(s):

European Society ◽

High Myopia ◽

Treatment Options ◽

Vision Impairment ◽

Pathological Myopia ◽

Myopia Progression ◽

Preventive Actions ◽

Prevalence Estimates ◽

Number Of Individuals ◽

Myopia Control

The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.

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