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

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.

scholarly journals Efficacy and safety of atropine to control myopia progression: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Congling Zhao ◽  
Chunyan Cai ◽  
Qiang Ding ◽  
Hongbin Dai
Keyword(s):  
Meta Analysis ◽  
Optimal Dose ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Myopia Progression ◽  
Central Register ◽  
Atropine Treatment ◽  
Observation Period

Abstract Background The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effectiveness of controlling the progression of myopia. Methods This work was done through the data searched from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of the included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than that in the control group, with MD = − 0.80, 95% CI (− 0.94, − 0.66) during the whole observation period. There was a statistical difference among 0.05, 0.5, and 1.0% atropine (P = 0.004). In addition, less axial elongation was shown, with MD = − 0.26, 95% CI (− 0.33, − 0.18) during the whole observation period. Conclusion The effectiveness of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.

scholarly journals Efficacy and Safety of Atropine to Control Myopia Progression: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Congling Zhao ◽  
Chunyan Cai ◽  
Qiang Ding ◽  
Hongbin Dai
Keyword(s):  
Meta Analysis ◽  
Optimal Dose ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Myopia Progression ◽  
Central Register ◽  
Atropine Treatment ◽  
Observation Period

Abstract Background: The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal effect dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effect of controlling the progression of myopia. Methods: This work was done through the data search from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of these included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results: A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than the control group, with MD = -0.80, 95% CI (-0.94, -0.66) during the whole observation period. There was a statistical difference between 0.05%, 0.5%, and 1.0% atropine (P = 0.004). In addition, less axial elongation was showed, with MD = -0.26, 95% CI (-0.33, -0.18) during the whole observation period. Conclusion: The effect of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.

Atropine Treatment for Hypertrophic Pyloric Stenosis: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 28 (05) ◽  
pp. 393-399 ◽  
Author(s):  
Valentina Cascini ◽  
Pierluigi Chiesa ◽  
Agostino Pierro ◽  
Augusto Zani ◽  
Giuseppe Lauriti
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Hospital Stay ◽  
Success Rate ◽  
Pyloric Stenosis ◽  
Case Reports ◽  
Meta Analysis ◽  
Hypertrophic Pyloric Stenosis ◽  
Length Of Hospital Stay ◽  
Atropine Treatment

Introduction Several authors have reported the use of atropine as an alternative treatment to pyloromyotomy in infants with hypertrophic pyloric stenosis (HPS). Our aims were to review the efficacy of atropine in treating HPS and to compare atropine therapy versus pyloromyotomy. Materials and Methods Using a defined search strategy (PubMed, MEDLINE, OVID, Embase, Cochrane databases), two investigators independently identified studies reporting the use of atropine for HPS. Case reports and opinion articles were excluded. Outcome measures included success rate, side effects, and length of hospital stay. Maneuvers were compared using Fisher's exact test, and meta-analysis was conducted using RevMan 5.3. Data are expressed as mean ± standard deviation. Results Systematic review: of 2,524 abstracts screened, 51 full-text articles were analyzed. There were no prospective or randomized studies. Twelve articles (508 infants) reported HPS resolution using atropine in 402 (79.1%) patients. Atropine side effects were documented in 38/251 (15.1%) infants and included tachycardia, increased transaminases, and flushed skin. Meta-analysis: five studies compared atropine treatment (293 infants) with pyloromyotomy (537 infants). Pyloromyotomy had higher success rate (100%) than atropine (80.8%; p < 0.01) and shorter hospital stay (5.6 ± 2.3 vs. 10.3 ± 3.8 days, respectively; p < 0.0001). Conclusion Comparative but nonrandomized studies indicate that atropine is less effective than pyloromyotomy to treat infants with HPS. Currently, there is no evidence-based literature to support atropine treatment in these infants. To our knowledge, atropine should be reserved for patients unfit for general anesthesia or surgery.

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

2021 ◽  
Author(s):  
Lutz Joachimsen ◽  
Navid Farassat ◽  
Tim Bleul ◽  
Daniel Böhringer ◽  
Wolf A. Lagrèze ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Reading Difficulties ◽  
Myopia Progression ◽  
Asian Children ◽  
German School ◽  
Atropine Treatment ◽  
Near Visual Acuity ◽  
Progressive Myopia ◽  
Myopia Control

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.

scholarly journals Efficacy and Safety of Atropine to Control Myopia Progression: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Congling Zhao ◽  
Chunyan Cai ◽  
Qiang Ding ◽  
Hongbin Dai
Keyword(s):  
Meta Analysis ◽  
Optimal Dose ◽  
Control Group ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Myopia Progression ◽  
Central Register ◽  
Atropine Treatment ◽  
Observation Period

Abstract Background: The effect and safety of atropine on delaying the progression of myopia has been extensively studied, but its optimal effect dose is still unclear. Therefore, the purpose of this meta-analysis is to systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia, and to explore the relationship between the dose of atropine and the effect of controlling the progression of myopia. Methods: This work was done through the data search from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of these included studies. In addition, a meta-analysis was performed using Revman5.3 software. Results: A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated greater in the atropine treatment group than the control group, with MD = -0.80, 95% CI (-0.94, -0.66) during the whole observation period. There was a statistical difference between 0.05%, 0.5%, and 1.0% atropine (P = 0.004). In addition, less axial elongation was showed, with MD = -0.26, 95% CI (-0.33, -0.18) during the whole observation period. Conclusion: The effect of atropine in controlling the progression of myopia was dose related. A 0.05% atropine was likely to be the optimal dose.

scholarly journals Efficacy and Safety of Atropine to Control Myopia Progression: a Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Congling Zhao ◽  
Chunyan Cai ◽  
Qiang Ding ◽  
Hongbin Dai
Keyword(s):  
Meta Analysis ◽  
Optimal Dose ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Myopia Progression ◽  
Randomized Controlled ◽  
Central Register ◽  
Atropine Treatment ◽  
Dose Dependent

Abstract Purpose: To systematically evaluate the safety and effectiveness of atropine in controlling the progression of myopia.Methods: This work was done through the data search from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The Cochrane Handbook was also used to evaluate the quality of these included studies. In addition, a meta-analysis was performed using Revman5.3 software.Results: A total of 10 randomized controlled trials (RCTs) were included. Myopia progression was mitigated in the atropine treatment group, with MD = -0.80, 95% CI (-0.94, -0.66). There was a statistical difference between 0.05%, 0.5%, and 1.0% atropine (P = 0.004). In addition, axial elongation was slowed, with MD = -0.26, 95% CI (-0.33, -0.18).Conclusion: The effect of atropine in controlling the progression of myopia was dose-dependent. A 0.05% atropine was most likely to be the optimal dose.

scholarly journals Ocular side effects of systemic isotretinoin: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Olivia Lamberg ◽  
Arianna Strome ◽  
Foster Jones ◽  
Julia Mleczek ◽  
Kathryn Vanderboll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Meta Analysis ◽  
Ocular Side
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