The Synergistic Effects of Orthokeratology and Atropine in Slowing the Progression of Myopia.

Lei Wan,Chang-Ching Wei,Ching-Yao Chang,Hui-Ju Lin,Peng-Tai Tien,Jamie Chen,Chih Chen,Chao-Jen Lin

doi:10.3390/jcm7090259

Abstract

Atropine and orthokeratology (OK) are both effective in slowing the progression of myopia. In the current study, we studied the combined effects of atropine and OK lenses on slowing the progression of myopia. This retrospective study included 84 patients who wore OK lenses and received atropine treatment (OA) and 95 patients who wore OK lenses alone (OK) for 2 years. We stratified patients into low (<6 D, LM) and high (≥6 D, HM) myopia groups, as well as two different atropine concentrations (0.125% and 0.025%). Significantly better LM control was observed in OA1 patients, compared with OK1 patients. Axial length was significantly shorter in the OA1 group (24.67 ± 1.53 mm) than in the OK1 group (24.9 ± 1.98 mm) (p = 0.042); similarly, it was shorter in the OA2 group (24.73 ± 1.53 mm) than in the OK2 group (25.01 ± 1.26 mm) (p = 0.031). For the HM patients, OA3 patients compared with OK3 patients, axial length was significantly shorter in the OA3 group (25.78 ± 1.46 mm) than in the OK3 group (25.93 ± 1.94 mm) (p = 0.021); similarly, it was shorter in the OA4 patients (25.86 ± 1.21 mm) than in the OK4 patients (26.05 ± 1.57 mm) (p = 0.011). Combined treatment with atropine and OK lenses would be a choice of treatment to control the development of myopia.

Highlights

Myopia is one of the major global causes of visual impairment and has an extensive impact on public health care systems and economies worldwide [1]
Twenty patients who were treated with OK lens + 0.125% atropine (OA1 group) and 26 patients treated with OK lens only (OK1 group) were enrolled
We found no differences between groups in accommodation, photopic pupil diameter, or mesopic pupil diameter at baseline; all were significantly different after 2 years, due to the mydriasis and cycloplegia side effects of atropine

Summary

Introduction

Myopia is one of the major global causes of visual impairment and has an extensive impact on public health care systems and economies worldwide [1]. 153 million individuals over the age of 5 years exhibit some distance visual impairment; 8 million of these individuals are effectively blind because of uncorrected refractive errors [2]. In Taiwan, the prevalence of myopia in 6-year-old children is 9.4% and reaches > 75% in 15-year-old adolescents. High myopia is a major cause of blindness because of its association with retinal detachment [3], macular choroidal degeneration [4,5], premature cataracts [5,6], and glaucoma [7]. High myopia increases the risk of macular choroidal neovascularization, which is up to 9-fold higher in patients with myopia ≥6 D [1,8]

Objectives

Methods

Results

Discussion

Conclusion