Abstract
Purpose To compare the patterns of relative peripheral refractions of myopic children who were currently on atropine treatment for myopia control and myopic children who did not use atropine. Methods Chinese children (n = 209) aged 7 to 12 years participated in the study, 106 used atropine and 103 did not. Participants were also classified into three groups: emmetropes (SE: +0.50 to −0.50 D), low myopes (SE: −0.50 to −3.00 D), and moderate myopes (SE: −3.00 to −6.00 D). The central and peripheral refractions along the horizontal meridians (for both nasal and temporal fields) were measured in 10-degree steps to 30 degrees. Results There were no statistically significant differences in spherical equivalent and astigmatism of the three refractive groups in either the nasal or temporal retina. The atropine group showed a significant relative myopia in the temporal 30° field in spherical equivalent compared to the emmetropic group (t49 = 3.36, P=0.02). In eyes with low myopia, the atropine group had significant relative myopia in the nasal 30° and temporal 30° fields (t118 = 2.59, P=0.01; t118 = 2.06, P=0.04), and it is also observed at 20° and 30° of the nasal field for the moderate myopic group (t36 = 2.37, P=0.02; t2.84 = 2.84, P=0.01). Conclusion Significant differences in relative peripheral refraction were found between the atropine group and its controls. The findings suggested that the eyes that received atropine may have a less prolate shape and thus explain why using atropine is effective in controlling myopia progression.
Highlights
Myopia is highly prevalent in China and Japan [1, 2] and in Taiwan, where 75% of school children are myopic [3]
For astigmatism J180, the atropine group showed more relative peripheral myopia at 20° and 30° of the temporal field and 10° and 30° of the nasal field compared to the nonatropine group, but there were no statistically significant differences
For astigmatism J45, the atropine group showed more relative peripheral myopia at 10° and 30° of the temporal field and 20° and 30° of the nasal field compared to the nonatropine group, but there were no statistically significant differences
Summary
Myopia is highly prevalent in China and Japan [1, 2] and in Taiwan, where 75% of school children are myopic [3]. In the atropine treatment of myopia trials (ATOM1 and ATOM2), lower doses of atropine (0.01%) slowed myopia progression by 60% over the first 24 months compared to placebo-treated eyes [8, 9]. E earliest record of its use for controlling mild myopia was in Taiwan which showed significant effect on reducing myopia progression in −1.00 D myopic teenagers (11 to 16 years) after 4 months of 1% atropine treatment. Low doses of atropine showed an effective power on slowing down myopia progression, but the rebound phenomenon still requires more long-term studies to address the issue [8, 9]
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