Analysis of treatment response about low-dose (0.01%) atropine eye-drops in myopic children

2021 ◽  
pp. 112067212110388
Author(s):  
Gang Seok Jeon ◽  
In Hwan Hong ◽  
Jang Hun Lee ◽  
Tae Geun Song ◽  
Tae Yeem Lee ◽  
...  
Keyword(s):  
Treatment Response ◽  
Low Dose ◽  
Poor Responder ◽  
Poor Responders ◽  
Eye Drops ◽  
Good Responder ◽  
Myopia Progression ◽  
Important Indicator ◽  
Before And After ◽  
The Mean

Introduction: Myopia usually commences during primary school and progresses until the mean age of 16 years. Topical low-dose (0.01%) atropine eye-drop appears to be safe and efficacious for myopia control in children. However, in some cases, a higher concentration of atropine is required in some cases because low-dose atropine treatment is not effective. Methods: This is a retrospective study among young myopic children between 5 and 15 years with myopia progression > 0.50 D/year. We selected patients treated with low-dose atropine (0.01%) eye-drops for 12 months and conducted a comparative analysis of the group with good responder and poor responder. Patients were classified as good responders if spherical equivalent refractive error (SE) progression was ⩽ 0.50 D after 12 months of treatment and poor responders if SE progression > 0.50 D. The prognostic factors before and after treatment were analyzed in two groups. Results: A total of 68 eyes were included. Low-dose (0.01%) atropine eye-drops have a good treatment response in 54% of patients. In the good responder group ( n = 37), the mean rate of myopia progression after 12 months of treatment (0.36 ± 0.17 D) was significantly slower compared with the baseline progression ( p < 0.001). Good responders have smaller changes in axial length (AL) elongation and SE than poor responders ( p < 0.001). The only adverse event was temporary near vision difficulty (10%), photophobia (10%), and mild pupil dilation (30%). Discussion: The AL elongation is an important indicator for monitoring the treatment response. Children with a family history of myopia at a young age may not respond well to low-dose (0.01%) atropine eye-drops. In these cases, increasing the concentration of atropine eye-drops should be considered.

scholarly journals The Effect of Long-Term Low-Dose Atropine on Refractive Progression in Myopic Australian School Children

2021 ◽  
Vol 10 (7) ◽  
pp. 1444
Author(s):  
William Myles ◽  
Catherine Dunlop ◽  
Sally A. McFadden
Keyword(s):  
Low Dose ◽  
High Dose ◽  
Eye Drops ◽  
Myopia Progression ◽  
At Risk Children ◽  
Slow Group ◽  
Blue Eyes ◽  
Global Population ◽  
Axial Growth

Myopia will affect half the global population by 2050 and is a leading cause of vision impairment. High-dose atropine slows myopia progression but with undesirable side-effects. Low-dose atropine is an alternative. We report the effects of 0.01% or 0.005% atropine eye drops on myopia progression in 13 Australian children aged between 2 and 18 years and observed for 2 years without and up to 5 years (mean 2.8 years) with treatment. Prior to treatment, myopia progression was either ‘slow’ (more positive than −0.5D/year; mean −0.19D/year) or ‘fast’ (more negative than −0.5D/year; mean −1.01D/year). Atropine reduced myopic progression rates (slow: −0.07D/year, fast: −0.25D/year, combined: before: −0.74, during: −0.18D/year, p = 0.03). Rebound occurred in 3/4 eyes that ceased atropine. Atropine halved axial growth in the ‘Slow’ group relative to an age-matched model of untreated myopes (0.098 vs. 0.196mm/year, p < 0.001) but was double that in emmetropes (0.051mm/year, p < 0.01). Atropine did not slow axial growth in ‘fast’ progressors compared to the age-matched untreated myope model (0.265 vs. 0.245mm/year, p = 0.754, Power = 0.8). Adverse effects (69% of patients) included dilated pupils (6/13) more common in children with blue eyes (5/7, p = 0.04). Low-dose atropine could not remove initial myopia offsets suggesting treatment should commence in at-risk children as young as possible.

scholarly journals Effect of low-dose atropine on myopia progression, pupil diameter and accommodative amplitude: low-dose atropine and myopia progression

2020 ◽  
pp. bjophthalmol-2019-315440 ◽  
Author(s):  
Aicun Fu ◽  
Fiona Stapleton ◽  
Li Wei ◽  
Weiqun Wang ◽  
Bingxin Zhao ◽  
...  
Keyword(s):  
Low Dose ◽  
Pupil Diameter ◽  
Repeated Measurements ◽  
Control Group ◽  
Eye Drops ◽  
Control Groups ◽  
Myopia Progression ◽  
Registration Number ◽  
And Control ◽  
Accommodative Amplitude

PurposeTo evaluate the effects of 0.01% and 0.02% atropine eye drops on myopia progression, pupil diameter and accommodative amplitude in myopic children.MethodsA cohort study assessed 400 myopic children divided into three groups: 138 and 142 children were randomised to use either 0.02% or 0.01% atropine eye drops, respectively. They wore single-vision (SV) spectacles, with one drop of atropine eye drop applied to both eyes once nightly. Control children (n=120) only wore SV spectacles. Repeated measurements of spherical equivalent refractive errors (SERs), axial length (AL), pupil diameter and accommodative amplitude were performed at baseline, and 4, 8 and 12 months after treatment.ResultsAfter 12 months, the SER change was −0.38±0.35D, −0.47±0.45D, −0.70±0.60D and AL change was 0.30±0.21 mm, 0.37±0.22 mm, 0.46±0.35 mm in the 0.02%, 0.01% atropine and control groups, respectively. There were significant differences in the change in AL and SER between three groups (all p<0.001). Between baseline and the 12-month visit, the overall change in accommodative amplitude was 1.50±0.25D, 1.61±0.31D and change in pupil diameter was 0.78±0.42 mm, 0.69±0.39 mm, with 0.02% and 0.01% atropine, respectively. Accommodative amplitude significantly decreased and pupil diameter significantly increased in two atropine groups (all p<0.001). Moreover, there was no statistical difference in the change difference in accommodative amplitude and pupil diameter between two atropine groups (p=0.24, p=0.38), whereas the accommodative amplitude (p=0.45) and pupil diameter (p=0.39) in the control group remained stable.Conclusions0.02% atropine eye drops had a better effect on myopia progression than 0.01% atropine, but 0.02% and 0.01% atropine showed similar effects on pupil diameter and accommodative amplitude after 12 months of treatment.Trial registration numberChiCTR-IPD-16008844.

scholarly journals Measuring vitamin B-12 bioavailability with [13C]-cyanocobalamin in humans

2020 ◽  
Vol 112 (6) ◽  
pp. 1504-1515 ◽  
Author(s):  
Sarita Devi ◽  
Roshni M Pasanna ◽  
Zeeshan Shamshuddin ◽  
Kishor Bhat ◽  
Ambily Sivadas ◽  
...  
Keyword(s):  
Stable Isotope ◽  
Low Dose ◽  
Age Groups ◽  
Fold Increase ◽  
Compartment Model ◽  
Radioactive Isotopes ◽  
Vitamin B ◽  
Before And After ◽  
Vitamin B 12 ◽  
The Mean

ABSTRACT Background Vitamin B-12 deficiency is widespread in many parts of the world, affecting all age groups and increasing with age. It is primarily due to a low intake of animal source foods or malabsorption. The measurement of bioavailability of vitamin B-12 is etiologically important in deficiency but is limited due to the use of radioactive isotopes like [57Co]- or [14C]-cyanocobalamin. Objectives The aim of this study was to measure the bioavailability of [13C]-cyanocobalamin in humans and to assess the effect of parenteral replenishment of vitamin B-12 on the bioavailability. Methods We synthesized a stable isotope-labeled vitamin B-12, [13C]-cyanocobalamin, using Salmonella enterica by providing [13C2]-ethanolamine as a sole carbon source. After purification and mass spectrometry–based characterization, its oral bioavailability was measured in the fasted state with high and low oral doses, before and after parenteral replenishment of vitamin B-12 stores, from the kinetics of its plasma appearance in a 2-compartment model. Results [13C]-cyanocobalamin was completely decyanated to [13C]-methylcobalamin describing metabolic utilization, and its plasma appearance showed early and late absorption phases. At a low dose of 2.3 µg, the mean bioavailability was 46.2 ± 12.8 (%, mean ± SD, n = 11). At a higher dose of 18.3 µg, the mean bioavailability was 7.6 ± 1.7 (%, mean ± SD, n = 4). Parenteral replenishment of the vitamin B-12 store in deficient individuals prior to the measurement resulted in a 1.9-fold increase in bioavailability. Conclusions Vitamin B-12 bioavailability is dose dependent and at a low dose that approximates the normal daily requirement (46%). The stable isotope method described here could be used to define the etiology of deficiency and to inform the dietary requirement in different physiologic states as well as the dose required for supplementation and food fortification. This trial was registered at the Clinical Trials Registry of India as CTRI/2018/04/012957.

scholarly journals Hospital-prepared low-dose atropine eye drops for myopia progression control using atropine sulfate injection diluted in normal saline and lubricants

2021 ◽  
Author(s):  
Nuthida Wongwirawat ◽  
Nirachorn Kuchonthara ◽  
Sorrawit Boontanomwong ◽  
Krit Pongpirul
Keyword(s):  
Normal Saline ◽  
Low Dose ◽  
Real Life ◽  
Chemical Properties ◽  
Atropine Sulfate ◽  
Eye Drops ◽  
Myopia Progression ◽  
Healthcare Facilities ◽  
Biological Contamination ◽  
Two Temperature

Abstract BackgroundAs commercial low-dose atropine eye-drops for myopia progression control are available in some countries, in-house preparation by diluting the 0.1% atropine eye-drop with sterile water or normal saline has been a common practice. Atropine injection is readily available and could be a more feasible alternative.ObjectiveTo assess the properties of the in-house low-dose atropine eye-drops prepared by diluting the atropine injection in two solvents and tested in two temperature conditions.MethodThe 0.01% atropine eye-drops (15ml) were prepared by diluting atropine sulfate injection with normal saline and lubricant eye-drops and stored at room temperature and in a refrigerator. All samples were daily dropped for 12 weeks to mimic real-life use, one of which was assessed every two weeks for the biological contamination and chemical properties. The active substance was compared with freshly prepared samples at the 12th week.ResultsThe 0.01% atropine eye-drops contains no bacteria, fungi, or particulate matter. The levels of atropine sulfate on all samples were comparable to the freshly prepared samples at the 12th week, regardless of the solvents used or storage conditions.ConclusionThe low-dose atropine eye-drops prepared from readily available atropine sulfate injection at healthcare facilities could be alternative to commercial products

Phase I trial of low-dose, prolonged continuous infusion fluorouracil plus interferon-alfa: evidence for enhanced fluorouracil toxicity without pharmacokinetic perturbation.

1993 ◽  
Vol 11 (8) ◽  
pp. 1609-1617 ◽  
Author(s):  
J A Sparano ◽  
S Wadler ◽  
R B Diasio ◽  
R Zhang ◽  
Z Lu ◽  
...  
Keyword(s):  
High Performance ◽  
Low Dose ◽  
Objective Response ◽  
Circadian Variation ◽  
Interferon Alfa ◽  
Pharmacokinetic Data ◽  
Ifn Alpha ◽  
Before And After ◽  
The Mean ◽  
Adenocarcinoma Of The Pancreas

PURPOSE To determine the maximum-tolerable dose (MTD) of fluorouracil (5-FU) administered as a low-dose, prolonged continuous intravenous infusion (PCI) plus interferon-alfa (IFN-alpha) that would permit treatment for at least 28 consecutive days, and to determine the effect of IFN-alpha on 5-FU pharmacokinetics. PATIENTS AND METHODS Twenty-six assessable patients with advanced cancer received low-dose PCI 5-FU (150, 200, 250, and 300 mg/m2/d) plus IFN-alpha, 5 x 10(6) IU/m2 administered subcutaneously (SC) at hour 48 of the 5-FU infusion, then thrice weekly thereafter in cohorts of at least three patients. Treatment continued until treatment-limiting toxicity (TLT) developed, such as mucositis, diarrhea, or fatigue. Escalation to the next 5-FU dose level occurred if none of three or zero to two of six patients developed TLT before day 28. Quantitation of plasma 5-FU concentration by high-performance liquid chromatography was performed in 15 patients. Data were standardized using the Cosinor method and compared before and after IFN-alpha administration using the paired t test. RESULTS The mean number of days of continuous 5-FU therapy for patients receiving 150, 200, 250, and 300 mg/m2/d of 5-FU plus IFN alfa-2a (IFN-alpha 2a) was 75, 54, 37, and 22 days, respectively. The MTD of PCI 5-FU by our criteria that could be combined with IFN-alpha was 250 mg/m2/d. Comparison of the standardized pharmacokinetic data showed no significant effect of IFN-alpha on plasma 5-FU concentration, and no alteration of the normal circadian variation in plasma 5-FU concentration that was evident before IFN-alpha administration. Objective response occurred in patients with adenocarcinoma of the pancreas (n = 3), kidney (n = 2), and lung (n = 1). CONCLUSION IFN-alpha substantially enhanced the gastrointestinal toxicity of low-dose PCI 5-FU without affecting 5-FU pharmacokinetics, contrary to previous reports using alternative 5-FU schedules in which IFN-alpha-related enhancement of 5-FU toxicity was attributable to reduced 5-FU clearance. Our findings suggest that under certain conditions, mechanisms other than altered 5-FU pharmacokinetics may be responsible for the ability of IFN-alpha to enhance the toxic effects of 5-FU.

scholarly journals Hospital-prepared Low-dose Atropine Eye Drops for Myopia Progression Control using Atropine Sulfate Injection Diluted in Normal Saline and Lubricants

2021 ◽  
Author(s):  
Nuthida Wongwirawat ◽  
Nirachorn Kuchonthara ◽  
Sorrawit Boontanomwong ◽  
Krit Pongpirul
Keyword(s):  
Normal Saline ◽  
Low Dose ◽  
Real Life ◽  
Chemical Properties ◽  
Atropine Sulfate ◽  
Eye Drops ◽  
Myopia Progression ◽  
Healthcare Facilities ◽  
Biological Contamination ◽  
Two Temperature

Abstract BackgroundAs commercial low-dose atropine eye-drops for myopia progression control are available in some countries, in-house preparation by diluting the 0.1% atropine eye-drop with sterile water or normal saline has been a common practice. Atropine injection is readily available and could be a more feasible alternative.ObjectiveTo assess the properties of the in-house low-dose atropine eye-drops prepared by diluting the atropine injection in two solvents and tested in two temperature conditions.MethodThe 0.01% atropine eye-drops (15ml) were prepared by diluting atropine sulfate injection with normal saline and lubricant eye-drops and stored at room temperature and in a refrigerator. All samples were daily dropped for 12 weeks to mimic real-life use, one of which was assessed every two weeks for the biological contamination and chemical properties. The active substance was compared with freshly prepared samples at the 12th week.ResultsThe 0.01% atropine eye-drops contains no bacteria, fungi, or particulate matter. The levels of atropine sulfate on all samples were comparable to the freshly prepared samples at the 12th week, regardless of the solvents used or storage conditions.ConclusionThe low-dose atropine eye-drops prepared from readily available atropine sulfate injection at healthcare facilities could be alternative to commercial products.

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

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.

scholarly journals Gabapentin for treatment of restless legs syndrome among hemodialysis patients; a pilot study

2018 ◽  
Vol 7 (2) ◽  
pp. 104-109
Author(s):  
Seyed Majid Mousavi Movahed ◽  
Gholamreza Alizadeh Attar ◽  
Fatemeh Hayati ◽  
Shahla Ahmadi Halili ◽  
Leila Sabetnia ◽  
...  
Keyword(s):  
Pilot Study ◽  
Restless Legs Syndrome ◽  
Low Dose ◽  
Hemodialysis Patients ◽  
Restless Leg Syndrome ◽  
Placebo Administration ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
To Receive

Introduction: Unfortunately the restless leg syndrome (RLS) is a neglected issue among hemodialysis (HD) centers. Objectives: The aim of our study was to find the efficacy of gabapentin at a low dose of 100 mg three times a week among HD patients with RLS. Patients and Methods: Around 21 patients with fulfilled the criteria of RLS were randomized to receive either gabapentin (100 mg) or placebo after HD session for 4 weeks. After 2 weeks of washout period, the patients were switched from gabapentin to placebo or placebo to gabapentin for another 4 weeks. Severity of RLS symptoms before and after management with medication or placebo was evaluated with standardized questionnaire. Results: Twenty-one patients (10 females and 11 males with mean age of 58 years) were enrolled to the study. Before the study, all patients had questionnaire scores of 16 or greater and the mean score was 24.19± 7.96. After gabapentin administration (before or after crossover), the mean score significantly decreased from 24.19± 7.96 to 19.24± 9.87 (P=0.04). The mean score before and after placebo administration (before or after crossover) were 24.19± 7.96 and 18.89± 11.15 with no significant difference (P=0.09). Conclusion: According to the results of the study gabapentin at a dose of 100 mg at the end of HD is a safe effective therapy for RLS. It can significantly reduce the intensity of RLS among these patients.

scholarly journals EFFICACY AND SAFETY OF LOW DOSE ATROPINE 0.01% IN SLOWING OF PROGRESSION OF MYOPIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Shalini Gupta ◽  
Poonam Gupta ◽  
Rashi Verma ◽  
Basudeb Gosh ◽  
Rakesh Bhardwaj
Keyword(s):  
Low Dose ◽  
Eye Drops ◽  
Efficacy And Safety ◽  
Visual Disability ◽  
Myopia Progression ◽  
Rapid Progressors ◽  
Significant Difference ◽  
Progressive Myopia

Background: Myopia, commonly referred to as short sightedness is a form of refractive error and is a very common cause of visual disability throughout the world. Methods: Hospital based prospective study conducted on 100 patients of Myopia attending to Department of Opthalmolgy. Results: There was no significant difference in the age, gender distribution, baseline myopia progression or follow-up duration between patients who used night application compared with daytime atropine. Effectiveness was better with daytime application. Conclusion: 1% atropine eye drops were well tolerated and efficacious for the retardation of progressive myopia in Indian eyes. Effectiveness was better with daytime application. Further studies are necessary to assess the role of 1% atropine in the rapid progressors and patients poorly responding to low-dose atropine. Keywords: Myopia, Atropine, low dose.

scholarly journals Hospital-prepared low-dose atropine eye drops for myopia progression control using atropine sulfate injection diluted in normal saline and lubricants

2021 ◽  
Author(s):  
Nuthida Wongwirawat ◽  
Nirachorn Kuchonthara ◽  
Sorrawit Boontanomwong ◽  
Krit Pongpirul
Keyword(s):  
Normal Saline ◽  
Low Dose ◽  
Real Life ◽  
Chemical Properties ◽  
Storage Conditions ◽  
Atropine Sulfate ◽  
Eye Drops ◽  
Myopia Progression ◽  
Healthcare Facilities ◽  
Feasible Alternative

Abstract Background As commercial low-dose atropine eye-drops for myopia progression control are available in some countries, in-house preparation by diluting the 0.1% atropine eye-drop with sterile water or normal saline has been a common practice. Atropine injection is readily available and could be a more feasible alternative.Objective To assess the properties of the in-house low-dose atropine eye-drops prepared by diluting the atropine injection in two solvents and tested in two temperature conditions.Method The 0.01% atropine eye-drops (15ml) were prepared by diluting atropine sulfate injection with normal saline and lubricant eye-drops and stored at room temperature and in a refrigerator. All samples were daily dropped for 12 weeks to mimic real-life use, one of which was assessed every two weeks for the biological contamination and chemical properties. The active substance was compared with freshly prepared samples at the 12th week.Results The 0.01% atropine eye-drops contains no bacteria, fungi, or particulate matter. The levels of atropine sulfate on all samples were comparable to the freshly prepared samples at the 12th week, regardless of the solvents used or storage conditions.Conclusion The low-dose atropine eye-drops prepared from readily available atropine sulfate injection at healthcare facilities could be alternative to commercial products

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