Effects of 0.01% and 0.02% atropine eye drops on pupil diameter and accommodation amplitude in myopic children: one-year randomized, double blind, controlled trail

Abstract

Objective To evaluate the effects of 0.0% and 0.02% atropine on pupil diameter (PD) and accommodation amplitude (AMP) in myopic children and analyze its relation factors. Methods A prospective randomized controlled trial design was adopted.One hundred and ninety-three myopia children were included from June to October, 2016 in the First Affiliated Hospital of Zhengzhou University, all the children completed one-year follow-up.All the children were divided into three groups randomly, with 72, 74 and 80 myopic children in 0.01% atropine group, 0.02% atropine group and control group, respectively.The myopic children in 0.01% atropine group and 0.02% atropine group wore single-vision spectacle lenses and were treated with 0.01% and 0.02% atropine eye drops nightly, respectively.The myopic children in the control group wore spectacle lenses only.The PD and AMP were measured at baseline, and 4, 8 and 12 months after treatment. Results There were no significant difference of baseline PD and AMP among the three groups (F=9.321, P=0.820; F=13.209, P=0.220). Compared with basline, after 12 months, the PD increased by 0.75, 0.84 and 0.02 mm in 0.01% atropine group, 0.02% atropine group and control group, respectively.There were statistically significant differences of PD among three groups at different time points (Fgroup=2.168, P=0.013; Ftime=2.139, P=0.015; Finteraction=2.148, P=0.001). Compared with baseline, the PD of 0.01% atropine group and 0.02% atropine group were increased 4, 8 and 12 months after treatment, and the difference was statistically significant (all at P<0.001). The PD was stable in control group.After 12 months, the AMP were reduced by 1.25, 1.12 and 0.28 D in 0.01% atropine group, 0.02% atropine group and control group, respectively.There were statistically significant differences of AMP among the three groups at the different time points (Fgroup=18.346, P=0.034; Ftime=1.823, P=0.002; Fintreatcion=3.239, P=0.023). Compared with baseline, the AMP of 0.01% atropine group and 0.02% atropine group were increased 4, 8 and 12 months after treatment, and the differences were statistically significant (all at P<0.05). The AMP remained stable in control group.The change of PD in 0.01% atropine group and 0.02% atropine group was correlated with age, baseline PD and baseline eye axis length, respectively (β=0.060, P=0.019; β=-0.440, P<0.001; β=-0.37, P=0.045). The change in AMP of the atropine group was significantly correlated with the baseline adjustment range (β=-0.71, P<0.001). Conclusions 0.01% and 0.02% atropine show similar effects on pupil diameter and accommodation amplitude after 12 months of treatment in myopic children. Key words: Children; Myopia; Atropine, low doses; Pupil diameter; Accommodation amplitude; Randomized double blind controlled trail