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    Low-dose atropine for myopia in children: two years of experience

    Nightly treatment with atropine drops can significantly slow progression

     

    2 years of treatment

    The children treated in the Assaf Herofeh Medical Centre, all of whom were progressing by at least 0.75 D/year, were initially given 0.01% atropine drops in both eyes every night. After 6 months, their myopia had stopped progressing (≤0.25 D) in almost all cases.

    “We were really amazed to see that after 6 months of treatment almost all children really stopped progressing,” Professor Morad said. “This is actually different from the study in Singapore [ATOM1], where the treatment did not have a profound effect in the first year.”

    There were no side effects reported. The mean age of the children at the start of treatment was 9.2 years and their mean refraction was –4.7 D (range –3 to –12 D). Myopia was moderate in 88% and severe (>7 D) in the remaining 12%. Most of the children (72%) had myopic parents.

    Only one child, who had a baseline refraction of –6.5 D and two parents with high myopia, continued to progress (by 0.75 D). His dose of atropine was increased to 0.05%.

    After 12 months (n = 56), most of the patients were still progressing by 0.5 D or less; two children progressed by 0.75 D (relative to baseline) so were switched to 0.05% atropine.

    After 18 months (n = 36), almost all the children had still not progressed more than 0.5 D; only three children progressed more than 0.75 D. And after 2 years (n = 16), 11 children had really stopped progressing, with a decrease of 0.5 D or less.

    The remaining five children continued to progress by 1 or 1.25 D, but this is a great result, Professor Morad said, bearing in mind that all these children progressed by at least 0.75 D per year before treatment, and that some were progressing by 1.5 or even 2 D per year.

    Myopia progression was reduced to <0.5 D per year in two of the three patients whose atropine dose was increased to 0.05%. One patient continued to progress but only by 1 D per year, which was still much better than the progression he had been experiencing before.

    The mean progression across all the children was 0.32 D per year. There were no side effects or discomfort reported, even in those children who received 0.05% atropine.

    The best responders were those who had low myopia and no family history. Those with high myopia and two myopic parents did not see such good results.

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