Abstract
Purpose To investigate the influences of atropine on changes in anterior segment geometry, as measured by ultrasound biomicroscopy in children. Methods A prospective observational study was performed. Anterior segment parameters were obtained by UBM before and after the instillation of 1% atropine. Univariate linear regression was performed to identify the variables contributing to the changes in the trabecular meshwork-iris angle (TIA). Results The study included 21 boys and 37 girls with a mean age of 10.79 ± 2.53 years. Anterior chamber parameters including the central anterior chamber depth, TIA, angle opening distance at 500 μm from the scleral spur, iris thickness 750 μm and 1500 μm from the scleral spur, trabecular-ciliary angle (TCA), trabecular-ciliary process distance, sclera-iris angle (SIA), and sclera-ciliary process angle significantly increased after cycloplegia (P < 0.05). In contrast, the lens vault, iris cross-sectional area, and maximum ciliary muscle thickness significantly decreased after cycloplegia. Univariate analysis identified the change in TCA and the change in SIA and the TIA before mydriasis as determinants of the change in TIA. Conclusions Atropine causes statistically significant changes in various anterior segment parameters in children. The change in anterior chamber angle is associated with the change in TCA and the change in SIA and the TIA before mydriasis.
Highlights
Myopia is a substantial public health problem that has especially affected children in Asia in recent decades [1,2,3]
The thickness of the iris increased significantly, the iris thickness at 750 μm (IT750) increased from 0.44 mm ± 0.1 mm to 0.55 mm ± 0.1 mm (P < 0.05), and the iris thickness at 1500 μm (IT1500) increased from 0.48 mm ± 0.07 mm to 0.58 mm ± 0.08 mm (P < 0.05). e iris cross-sectional area decreased significantly, and the iris area (IA) decreased from 1.87 mm2 ± 0.27 mm2 to 1.36 mm2 ± 0.21 mm2 (P < 0.05)
The thickness of the ciliary body in the iris root did not change significantly, and the CMTmax decreased from 0.68 ± 0.08 to 0.58 ± 0.08 (P < 0.05). e ciliary process showed a significant backward rotation, the trabecular-ciliary angle (TCA) increased from 70.54° ± 13.02° to 86.47° ± 14.39° (P < 0.05), and the trabecular-ciliary process distance (TCPD) increased from 1.06 mm ± 0.15 mm to 1.18 mm ± 0.17 mm (P < 0.05)
Summary
Myopia is a substantial public health problem that has especially affected children in Asia in recent decades [1,2,3]. Us, preventing the development of myopia would strongly affect public health. Recent studies have suggested that atropine shows promise in myopia control [5,6,7]. A recent meta-analysis examining interventions for myopia control has reported that high-dose atropine (1% and 0.5%) is significantly superior to other interventions such as orthokeratology, peripheral defocus modifying contact lenses, and specially designed spectacle lenses [8]. Angle closure is rare in children and young adults [11], some controversies exist regarding the changes in anterior chamber parameters after cycloplegia, especially regarding measurement of the anterior chamber angle [12,13,14]
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