Abstract
AbstractPurposeTo investigate 2‐year changes in macular choroidal thickness (ChT) in children receiving 0.01% atropine eyedrops and its relationship with spherical equivalent refraction (SER) progression and axial length (AL) elongation.MethodsA total of 250 myopic children aged 6–16 years (167%–0.01% atropine, 83‐placebo) were enrolled in the MOSAIC (ISRCTN36732601) clinical trial. Participants with complete 2‐year ChT (Topcon Triton Swept‐Source OCT), SER, and AL data were included in this study. Changes in macular ChT at 2 years and associations with changes in SER and AL elongation were analysed using linear mixed models.ResultsA total of 187 children (126%–0.01% atropine, 61‐placebo) were included in the analysis. Choroidal thickness over 2 years was stable in the 0.01% atropine compared with placebo group, which exhibited consistent thinning in subfoveal (mean ± SE: 0.49 ± 2.22 μm vs. −9.46 ± 2.69 μm; p = 0.034), parafoveal (1.40 ± 1.73 μm vs. −8.11 ± 2.08 μm; p = 0.002), and perifoveal (0.80 ± 1.25 vs. −6.17 ± 1.69; p = 0.002) macular subfields. Choroidal thickening was observed in participants with slower axial eye growth and myopia progression, regardless of their treatment group. Mediation analysis indicated that atropine 0.01% had a significant effect on ChT, with 68.3% of the effect being direct and 31.7% mediated through axial length changes. For SER, the direct effect on ChT was 80%, with the remaining 20% mediated by SER changes.ConclusionsMyopic participants treated with 0.01% atropine exhibited stable ChT over 2 years, whereas the placebo group showed consistent thinning. The effect of atropine 0.01% on ChT was only partially explained by axial length and SER changes, indicating a direct effect of atropine treatment on the choroid.
Published Version
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