Dilating eye drops may delay, and possibly even prevent, the onset of myopia in children, study finds Published today of jam. This study was conducted by researchers from Hong Kong.
Myopia, once established, is irreversible and can lead to other vision problems such as macular degeneration. retinal detachmentglaucoma, and Cataract. Incidence of myopia nearly doubled Since the 1970s, it has grown from 25% to nearly 42% of the US population. Children are particularly affected by the increase. Experts say the reasons could include spending more time looking at screens indoors.
“Myopia is an ongoing global concern. It’s important,” said Jason C. Yam, M.P.H. Department of Ophthalmology and Visual Services, The Chinese University of Hong Kong said: Medscape Medical News.
Encouraging children to participate more in outdoor activities and spend less time with screens can help slow myopia, but pharmaceutical intervention is needed given the potential lifelong effects of myopia, says Yam. is.
test eye drops
2020 Yam and Friends reported results low concentration Atropine The Myopia Progression (LAMP) study showed that eye drops containing 0.05% atropine solution were most effective in slowing the progression of myopia in children aged 4 to 12 who already had myopia. rice field. Atropine relaxes the eye muscles, causing dilation.
In that study, Yam and colleagues measured the rate of change in the eye’s ability to see at great distances using a unit of measurement known as diopter. The higher the diopter, the more myopic a person’s vision. A 0.05% atropine solution was better at slowing this decline than placebo or solutions containing low concentrations of atropine.
The new study enrolled 474 children evenly split by gender. No children were myopic at the start of the study. Of that starting group, 353 children (ages, 4-9 years) completed the study. This included once nightly eye drops in both eyes for 2 years.
Some children (n = 116) received 0.05% atropine, others (n = 122) received 0.01% atropine, and the remaining children (n = 115) received placebo drops. rice field. Yam and his colleagues assessed how many children in each group became myopic two years after her. This was measured by a decrease of at least 0.5 diopters in one eye.
At 2 years, more than half (61/115) of the children receiving the placebo drops developed myopia, and almost half (56/122) of the children receiving 0.01% atropine developed myopia. However, less than one-third of her children (33/116, 28.4%) who received an infusion containing 0.05% atropine developed myopia during that period, researchers report.
The proportion of myopic children in the placebo group (39/128, 30.5%) was greater by the end of the first year of the study than in the 0.05% atropine group by the end of the trial. (Between 12 and 24 months, 13 of her children in the placebo group left the study.) The main adverse event in all treatment groups, according to the researchers, was exposure to bright light. It was an uncomfortable feeling.
“We are continuing our current study and plan to have a total follow-up period of at least six years.Yam added that he wants to determine whether a 0.05% atropine solution not only slows myopia, but also prevents it altogether. especially prevalent in East Asia.
Mark A. Bullimore, MCOptom, PhD, FAAO, an adjunct professor at the University of Houston College of Optometry and a consultant to an ophthalmic company, called the trial “groundbreaking research.” A two-year drop is no easy feat.
“0.05% atropine delays the onset of myopia by an average of one year,” says Dr. Brimore. He noted similar percentages of myopia with placebo at 12 months compared to his 0.05% atropine after 1 year. Few clinicians in the United States use more than 0.05% atropine to control myopia, he added.
Brimore said that while preventing myopia entirely would be ideal, simply delaying its onset could have tangible benefits. published last monthBullimore and Noel A. Brennan of Johnson & Johnson Vision showed that delaying the onset of myopia reduces the severity of myopia.
“Optometrists are already prescribing low-dose atropine for myopia control, and in light of this study, there’s no reason not to do it to slow the onset,” Brimore said.
but, editorial Accompanying the journal article, David A. Berntsen (OD, PhD) and Jeffrey J. Walline (OD, PhD) from the University of Houston write that it is premature to change practices.
“The evidence presented does not warrant changes in the standard of care for children, as the long-term effects of delaying the onset of myopia with low-concentration atropine are not yet known,” they wrote.
They note that it is “difficult” to identify children who should be considered for treatment because children who are not myopic typically do not have routine check-ups unless they fail a vision test.
“Eventually, it will be necessary to perform vision screenings, including determining prescriptions for children, to identify those most likely to be myopic who may benefit from low-dose atropine.” wrote Berntsen and Walline.
Yam and co-workers have applied for a patent on a 0.05% atropine solution. Bullimore reports relationships with Alcon Research, Inc, CooperVision, Inc, CorneaGen, Inc, EssilorLuxottica SA, Eyenovia, Inc, Genentech, Inc, Johnson & Johnson Vision, Inc, Lentechs, LLC, Novartis AG, Vyluma, Inc. and sole owner of Ridgevue Publishing, LLC and Ridgevue Vision LLC.
jam. Published online on February 14, 2023. overview, editorial
Marcus A. Banks, Massachusetts is a New York City-based journalist who covers health news with a focus on new cancer research. His work has been published in Medscape, Cancer Today, The Scientist, Gastroenterology and Endoscopy News, Slate, TCTMD and Spectrum.
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