A Three Year Follow-Up Study of Atropine Treatment for Progressive Myopia in Europeans
Jan Roelof Polling; Emily T.C. Tan; J. Willem L. Tideman; Caroline C.W. Klaver
Rotterdam, The Netherlands
Introduction: Atropine is the most effective treatment for myopia. This study explores the 3-year efficacy of atropine 0.5% for progressive high myopia in a clinical setting, and the risk factors for poor response.
Methods: We performed an effectiveness study of atropine eye drops for progressive myopia in a university clinic. We included children who had 3 year consecutive data using atropine eye drops 0.5% daily (N=109). A standardized eye examination, including cycloplegic refraction and axial length at baseline was performed with follow up every 6 months. Chi-square analysis was used to evaluate risk factors associated with progression of myopia during atropine treatment.
Results: At baseline, median age was 9(IQR 5) years, the median spherical equivalent (SphE) -5.56D(IQR 3.75) and median axial length (AL) 25.03mm(IQR 1.28). Adherence to therapy was 73%. The median annual progression before treatment was -1.1D(IQR 0.97) and the median annual progression over a three year period for SphE was -0.31D(IQR 0.77) and for AL 0.12mm(IQR 0.27). Age at start of therapy was a risk factor, children <10-years had median annual progression of -0.38D/year and >/=10-years -0.25D.(P=0.01)
Discussion: Atropine for progressive myopia has an inhibiting effect on SE and AL over a 3-year period. On average, 15% of children did not meet treatment target and progressed 1D or more per year.
Conclusion: Atropine 0.5% is effective for the majority of European children with progressive myopia over a period of 3 years. Atropine treatment was less effective in children under 10-years and may need to be combined with additional interventions to arrest progression.