Low-concentration atropine eye drops are associated with lower incidence of myopia in children

A new study investigated the effect of low-concentration atropine eye drops at concentrations of 0.05% and 0.01% compared with placebo to delay disease onset. myopia For children ages 4 to 9.

Findings from the Low Concentration Atropine for Myopia Prevention (LAMP2) Trial show that nightly use of 0.05% atropine eye drops significantly reduced the incidence of myopia over two years, whereas 0.01% atropine was superior to placebo. No significant difference was observed in comparison.¹

“Of note, the results of this study could not be interpreted as preventing myopia or reducing future risk, as the study was only two years old.¹ “Furthermore, the results of this study suggest a delay in the onset and progression of myopia rather than prevention. We provide evidence for atropine as an additional strategy for

Early onset of myopia onset is likely to result in high myopia later in life, and this condition is irreversible once it develops. Lifestyle changes have been shown to delay the onset of myopia. However, there are benefits to additional strategies, especially for children who are at high risk of developing myopia.

Low-dose atropine eye drops are widely used in Asian countries to slow the progression of myopia, but it is unclear whether atropine treatment is effective in delaying the onset of myopia. The LAMP2 trial at the Chinese University of Hong Kong Eye Center evaluated the efficacy of low-dose atropine in delaying the onset of myopia in children. The researchers, led by MPH’s Jason C. Yam, recruited participants to begin treatment in July 2017, with the last participant he enrolled in June 2020. A final follow-up session he took place in June 2022.

The child must have at least one parent with cycloplegic spherical equivalent between +1.00 and 0.00 D, astigmatism less than -1.00 D, anisometropic less than 2.00 D, and myopia with spherical equivalent greater than -3.00 D. there was. All enrolled children were randomized in a 1:1:1 ratio to receive nightly 0.05% atropine, 0.01% atropine, or placebo eye drops in both eyes at the baseline visit.

The investigator followed the participants on the same schedule from 2 weeks after baseline to 24 months after baseline. The primary outcomes defined in this study were participants with a cumulative incidence of myopia (at least −0.50 D cycloplegic spherical equivalent in either eye) and rapid myopic shift (at least 1.00 D spherical equivalent myopic shift). was the proportion of

Of 474 randomized participants (mean age 6.8 years, 50% female), 353 (74.5%) completed the study after 121 participants dropped out during the 2-year follow-up period Did. Results showed that the 2-year cumulative incidence of myopia among study participants was 28.4% (33/116) in the 0.05% atropine group, 45.9% (56/122) in the 0.01% atropine group, and 53.0% (115/122) in the atropine group. 61 out of 10 people). ) for the placebo group. His 2-year rate of rapid myopic change in these groups was 25.0%, 45.1%, and 53.9%, respectively.

Compared to placebo, the 0.05% atropine group showed a significantly lower 2-year cumulative myopia incidence (difference, 24.6%; 95% confidence interval [CI], 12.0% – 36.4%) and the proportion of patients with rapid myopic shift (difference, 28.9%; 95% CI, 16.5% – 40.5%). Next, compared with the 0.01% atropine group, the 0.05% atropine group had a 2-year cumulative myopia incidence (difference 17.5%; 95% CI 5.2% – 29.2%) and the proportion of patients with rapid myopia change (difference 20.1%). ) was significantly lower. %; 95% CI, 8.0%–31.6%).

The researchers noted that there was no significant difference between the 0.01% atropine group and the placebo group at two years in the incidence of myopia or the proportion of patients with rapid myopic change.

“These results suggest that a concentration of 0.01% atropine may not be sufficient to have sufficient therapeutic effect,” the researchers added.¹

References

1. Yam JC, Zhang XJ, Zhang Y, et al. Effect of low-concentration atropine eye drops versus placebo on the incidence of myopia in children: the LAMP2 randomized clinical trial. jam. 2023;329(6):472–481. doi:10.1001/jama.2022.24162