This article is more than 5 years old. Information may no longer be current.
Lower doses of atropine yield less rebound
Click Here to Manage Email Alerts
Whereas level I evidence supports the use of topical atropine to prevent myopic progression of up to 1 D per year in pediatric patients, higher doses have been shown to increase rates of myopic rebound, according to an American Academy of Ophthalmology report.
Researchers reviewed 17 level I, II and III studies of children with myopia who had been treated with atropine ophthalmic solution of varying concentrations – 1%, 0.5%, 0.1% and 0.01% – to prevent myopia progression.
All eight of the level I and II studies evaluating myopic progression revealed less progression with atropine treatment. Patients treated with atropine experienced mean progression of 0.04 D to 0.47 D over 1 year of treatment compared with control patients who experienced 0.38 D to 1.19 D.
The evidence showed that patients treated with higher dose atropine experienced slightly more effective myopic progression outcomes during treatment periods of 1 to 2 years, but was associated with higher rebound myopic progression. After treatment cessation, patients in the 0.5% atropine cohort experienced mean myopic progression of 0.87 D per year compared with 0.28 D per year in the atropine 0.01% group.
“In addition, lower doses seem to be associated with fewer side effects, such as light sensitivity and accommodative insufficiency,” the authors reported. “Given the more sustained effect of atropine 0.01% coupled with the lower incidence of adverse effects, this review suggests that
it may represent the most reasonable approach to myopia retardation in children; however, the optimal time to initiate and discontinue therapy is still not known.” – by Robert Linnehan
Disclosures: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts