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

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 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 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 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 The Effects of 0.01% Atropine on Adult Myopes’ Contrast Sensitivity

2021 ◽  
Vol 15 ◽  
Author(s):  
Ziyun Cheng ◽  
Jianhui Mei ◽  
Suqi Cao ◽  
Ran Zhang ◽  
Jiawei Zhou ◽  
...  
Keyword(s):  
Contrast Sensitivity ◽  
Low Dose ◽  
Randomized Study ◽  
Eye Drops ◽  
Short Term ◽  
Myopia Progression ◽  
Significant Interaction Effect ◽  
Corrected Visual Acuity ◽  
To Receive

PurposeAtropine at a low concentration is considered a safe and effective treatment to mitigate myopia progression. However, the potential unwanted side effects of administering atropine at a low dose on visual functions other than best corrected visual acuity has not been investigated. In this study, we investigate the short-term (12,16, and 20 h) and long-term (1, 2, and 4 weeks) effects of 0.01% atropine (i.e., 0.1 mg/ml) on contrast sensitivity (CS) in patients with myopia.MethodsThirty adults (23.33 ± 2.93 years old) with myopia between -1.00 and -6.00 diopters (D), astigmatism of -1.50 D or less, and anisometropia of 1.00 D or less, participated in this prospective, masked, placebo-controlled, randomized study. The participants were randomly assigned to receive 0.01% atropine or polyvinyl alcohol eye drops once nightly to both eyes for four weeks. CS was measured binocularly at baseline and 12, 16, 20 h, 1, 2, and 4 weeks after the first use of the eye drops.ResultsThere was no statistically significant differences of CS found between atropine and placebo-controlled groups in both short-term and long-term. There was no statistically significant interaction effect found between the time and group.ConclusionWe demonstrated no significant deleterious effect of 0.01% atropine on adult myopes’ CS.

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 Single-center real-life experience with low-dose ipilimumab monotherapy in adjuvant setting for patients with stage III melanoma

2019 ◽  
Vol 29 (6) ◽  
pp. 648-654 ◽  
Author(s):  
Joanna Mangana ◽  
Florentia Dimitriou ◽  
Ralph Braun ◽  
Sabine Ludwig ◽  
Reinhard Dummer ◽  
...  
Keyword(s):  
Low Dose ◽  
Life Experience ◽  
Real Life ◽  
Stage Iii ◽  
Adjuvant Setting ◽  
Single Center ◽  
Stage Iii Melanoma

scholarly journals Intravitreal brimonidine inhibits form-deprivation myopia in guinea pigs

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Yifang Yang ◽  
Junshu Wu ◽  
Defu Wu ◽  
Qi Wei ◽  
Tan Zhong ◽  
...  
Keyword(s):  
Guinea Pig ◽  
Intravitreal Injection ◽  
Guinea Pigs ◽  
Intravitreal Injections ◽  
Eye Drops ◽  
Rna Seq ◽  
Myopia Progression ◽  
Expression Levels ◽  
Guinea Pig Model ◽  
Administration Methods

Abstract Background The use of ocular hypotensive drugs has been reported to attenuate myopia progression. This study explores whether brimonidine can slow myopia progression in the guinea pig form-deprivation (FD) model. Methods Three-week-old pigmented male guinea pigs (Cavia porcellus) underwent monocular FD and were treated with 3 different methods of brimonidine administration (eye drops, subconjunctival or intravitreal injections). Four different concentrations of brimonidine were tested for intravitreal injection (2 μg/μL, 4 μg/μL, 20 μg/μL, 40 μg/μL). All treatments continued for a period of 21 days. Tonometry, retinoscopy, and A-scan ultrasonography were used to monitor intraocular pressure (IOP), refractive error and axial length (AL), respectively. On day 21, guinea pigs were sacrificed for RNA sequencing (RNA-seq) to screen for associated transcriptomic changes. Results The myopia model was successfully established in FD animals (control eye vs. FD eye, respectively: refraction at day 20, 0.97 ± 0.18 D vs. − 0.13 ± 0.38 D, F = 6.921, P = 0.02; AL difference between day 0 and day 21, 0.29 ± 0.04 mm vs. 0.45 ± 0.03 mm, F = 11.655, P = 0.004). Among the 3 different brimonidine administration methods, intravitreal injection was the most effective in slowing myopia progression, and 4 μg/μL was the most effective among the four different concentrations of brimonidine intravitreal injection tested. The AL and the refraction of the brimonidine intravitreal injection group was significantly shorter or more hyperopic than those of other 2 groups. Four μg/μL produced the smallest difference in AL and spherical equivalent difference values. FD treatment significantly increased the IOP. IOP was significantly lower at 1 day after intravitreal injections which was the lowest in FD eye of intravitreal injection of brimonidine. At day 21, gene expression analyses using RNA-seq showed upregulation of Col1a1 and Mmp2 expression levels by intravitreal brimonidine. Conclusions Among the 3 different administration methods, intravitreal injection of brimonidine was the most effective in slowing myopia progression in the FD guinea pig model. Intravitreal brimonidine at 4 μg/μL significantly reduced the development of FD myopia in guinea pigs. Expression levels of the Col1a1 and Mmp2 genes were significantly increased in the retinal tissues of the FD-Inj-Br group.

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