http://www.medscape.com/viewarticle/752549
NEW YORK (Reuters Health) Oct 28 - Eye drops of 0.01% atropine control myopia progression in children almost as effectively as 1.0% atropine drops, but with minimal adverse effects, according to a new report in Ophthalmology.
"Atropine 0.01% is currently not commercially available. However, these findings collectively suggest that a nightly dose of atropine at 0.01% seems to be a safe and effective regimen for slowing myopia progression in children, with minimal impact on visual function," said Dr. Donald Tan, with the Singapore National Eye Center, and colleagues in an October 1st paper.
According to the authors, randomized trials -- including one of theirs - have shown that eye drops with atropine in concentrations of 1.0% and 0.5% can slow myopia progression, but effects on pupil size and accommodation have been a drawback.
To find a better balance between efficacy and adverse effects, the team randomly assigned 400 children, ages six to 12 and with myopia of at least -2.0 diopters, to nightly administration of 0.5%, 0.1% or 0.01% atropine in both eyes for two years.
Initially, the researchers explain, the lowest dose was intended to serve as a control as it was assumed to be ineffective, but this turned out not to be the case.
Mean myopia progression at two years in the three groups was -0.30, -0.38, and -0.49 D, respectively, Dr. Tan and colleagues found. By comparison, in their previous study, two-year progression was -0.28 D with 1.0% atropine and -1.20 D with placebo.
The authors say the between-groups difference of 0.19 D in myopia progression in the current study is clinically insignificant. On the other hand, 0.01% atropine had negligible effects on pupil size and accommodation.
Furthermore, the most common adverse effect -- allergic conjunctivitis and dermatitis -- occurred in 16 patients in the 0.5% and 0.1% groups, but in none of the children in the 0.01% arm, the report indicates
Summing up, the team concludes that 0.01% atropine "is a viable concentration for reducing myopia progression in children, while attaining a clinically significant improved safety profile in terms of accommodation, pupil size, and near visual acuity, and subsequently reduced adverse impact on visual function."
SOURCE: http://bit.ly/t16WB0
Ophthalmology 2011.
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