Atropine Group Research Articles

Effect of 0.02% and 0.01% atropine on astigmatism: a two-year clinical trial

BackgroundTo evaluate the effects of 0.02% and 0.01% atropine eye drops on ocular and corneal astigmatism over 2 years.MethodsA prospective clinic-controlled trail. The cohort study assessed 400 myopic children and divided them into three groups: 138 and 142 children were randomized to use either 0.02% or 0.01% atropine eye drops, respectively. They wore single-vision (SV) spectacles, with one drop of atropine applied to both eyes once nightly. Control children (n = 120) only wore SV spectacles. Spherical equivalent refractive errors (SER) and corneal curvature were measured every 4 months. The SER and corneal curvature were assessed by cycloplegic autorefraction and IOLMaster. Ocular and corneal astigmatism were calculated by Thibos vector analysis and then split into its power vector components, J0 (with-the-rule astigmatism) and J45 (oblique).ResultsAfter 2 years, the ocular astigmatism increased by -0.38 ± 0.29 D, -0.47 ± 0.38 D, -0.41 ± 0.35 D in the 0.02%, 0.01% atropine groups and control group, respectively (p = 0.15). The corresponding corneal astigmatism increased by -0.20 ± 0.34 D, -0.28 ± 0.35 D and -0.26 ± 0.26 D (p = 0.18). The ocular astigmatism J0 increased by 0.19 ± 0.28 D, 0.22 ± 0.36 D, 0.18 ± 0.31 D in the 0.02% atropine, 0.01% atropine and control groups, respectively (p = 0.65). The corresponding corneal astigmatism J0 increased by -0.05 ± 0.34 D, -0.11 ± 0.37 D and -0.13 ± 0.30 D (p = 0.23). There was a small but significant increase in ocular astigmatism (including J0) (all P < 0.05), but there were no changes in the ocular astigmatism J45 and corneal astigmatism (including J0 and J45) in the three groups over time (all p > 0.05). However, there were no significant differences in the changes in ocular astigmatism (including J0) among the three groups.ConclusionsTreatment with 0.02% and 0.01% atropine had no clinically significant effect on ocular and corneal astigmatism over 2 years.Trial registrationThe First Affiliated Hospital of Zhengzhou University, ChiCTR-IPD-16008844. Registered 14/07/2016.

Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children.

IntroductionTo explore the short-term effects of atropine 0.01% on the structure and vasculature of the choroid and retina in myopic Chinese children.MethodsThis study was a single-center randomized clinical trial. A total of 40 subjects with myopia < − 6.0 D were enrolled and randomized to receive atropine 0.01% once nightly with regular single-vision lenses or to simply wear regular single-vision lenses at an allocation ratio of 1:1. Follow-up visits were planned at 1 month and 3 months. Choroidal thickness (ChT) was obtained by optical coherence tomography (OCT). Retinal vessel density (RVD), retinal thickness (RT), foveal avascular zone (FAZ) and choriocapillaris flow (CCF) were measured by optical coherence tomography angiography (OCTA). The RVD and RT were measured at fovea, parafovea and perifovea area and four quadrants.ResultsTwenty-one subjects were allocated into the atropine group and 19 subjects into the control group. Over 3 months, the control group showed greater progression of myopia than those in the atropine group. ChT in the atropine group increased 11.12 ± 13.96 μm, which was not significant compared with that of the control group. None of the retinal sectors in atropine-treated eyes showed significant changes of RT and RVD compared with the control group. Besides, FAZ and CCF of the atropine group were not affected by atropine use over time, and there was no difference between the two groups.ConclusionAdministration of atropine 0.01% eye drops demonstrated no effect on RVD, FAZ and CCF over 3 months, while a modest increase of ChT was observed in atropine-treated eyes.Trial Registration NumberChiCTR1800017154.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-022-00476-0.

Atropine Affects the Outer Retina During Inhibiting Form Deprivation Myopia in Guinea Pigs

ABSTRACT Purpose Atropine has been proven to be effective in retarding myopia progression. However, the underlying mechanism remains unknown. Our purpose was to detect morphological and functional changes caused by atropine during myopic inhibition. Method Twenty 2-week-old guinea pigs were randomly assigned to either the saline group (n = 10) or the atropine group (n = 10). Form-deprived myopia (FDM) and intravitreal injections were applied on the right eyes. The injections were given every 3 days, lasting for 2 weeks. The left eyes served as control. Ocular refraction, axial length, retinal, and choroidal thickness were collected at the start and the end of the experiment. Retinal function was evaluated via full-field electroretinogram (ERG) at the end of treatment. Results The interocular differences (experimental eye minus control eye) of refraction error (RE), vitreous chamber depth (VCD), and axial length (AL) in the saline group were significantly greater than those in the atropine group (RE, VCD: P < .001, AL: P < .0001). The differences in choroidal thickness between the two groups did not reach statistical significance. However, a decreasing trend of choroidal thickness was observed in the saline group but not in the atropine group. Furthermore, the interocular differences of total retinal and outer retinal thickness in the atropine group were much thicker than in the saline group (P < .001 and P < .01, respectively). The treatment did not affect inner retinal thickness. In photopic ERG, the atropine-treated FDM eyes showed significantly greater a-wave amplitudes compared to the saline group. Conclusion During the process of inhibiting FDM, atropine showed an effect on the outer retina, most likely on the cones, in guinea pigs.

Mechanism of Myopic Defocus or Atropine for Myopia Control: Different or Similar Ways?

Introduction: Myopia is usually caused by excessive elongation of the eye during development. This condition is common worldwide. In clinical practice, the progression of myopia is commonly controlled through optical or drug measures, but the specific mechanisms underlying these two treatments remain unclear. To verify whether the effects of these two treatments on posterior-pole tissues are similar or different, we studied a set of common transcriptional changes in chicken models. Methods: Chicks were divided into four groups, and they were given the intervention measures of plus-lens induction, minus-lens induction, minus-lens induction with atropine injection, and minus-lens induction with saline injection. Then, the genetic changes in each tissue at the posterior pole were detected, and the results of different genes were compared. A semiquantitative real-time polymerase chain reaction method was used to further study the visually induced changes in the transcription of potential candidate genes. Results: Based on RNA sequencing (RNA-seq) analysis of the transcriptome, we identified variations between the differentially expressed transcripts in three tissues from the two treatment groups. Through Kyoto Encyclopedia of Genes and Genomes enrichment analyses, eukaryotic protein translation elongation factor 1α2 (EEF1A2) was enriched in the “leishmaniasis” pathway in the choroid and showed increased expression in both the plus-lens induction and injection atropine groups. The expression levels of selected genes verified by quantitative real-time PCR were concordant with the RNA-seq data. Conclusions: Overlapping differentially expressed mRNAs of only one-tenth could suggest a different mechanism of myopic defocus and intravitreal injection of atropine controlling myopia. EEF1A2 might play an important role in the choroid during the treatment of myopia.

Efficacy and Adverse Effects of Atropine for Myopia Control in Children: A Meta-Analysis of Randomised Controlled Trials.

Objectives To explore the rebound effects and safety of atropine on accommodation amplitude in slowing myopia progression. Methods We conducted a meta-analysis to testify proper dosage of atropine in children with myopia. We searched in PubMed, EMBASE, Ovid, and the Cochrane Library up to March 30, 2021. We selected randomised controlled trials (RCTs) that evaluated the efficacy of atropine for controlling myopia progression in children. We performed the inverse variance random-effects model to pool the data using mean difference (MD) for continuous variables. Statistical heterogeneity was assessed using the I2 test. Additionally, we conducted subgroup analyses and sensitivity analyses. Results Seventeen RCTs involving 2955 participants were included. Myopia progression was significantly less in the atropine group than that of the control group, with MD = 0.38 D per year (95% confidence interval, 0.20 to 0.56). Less axial elongation was shown with MD = −0.19 mm per year (95% CI, −0.25 to −0.12). There was a statistically difference among various doses (p=0.00001). In addition, 1.0% atropine showed the rebound effect with MD = −0.54 D per year (95% CI, −0.81 to −0.26) and was more effective in the latter six months than in the former one. Less accommodation amplitude was shown in 0.01% atropine. Conclusion The efficacy of atropine is dose dependent, and 0.01% atropine may be the optimal dose in slowing myopia progression in children with no accommodation dysfunction. A rebound effect is more prominent in high-dose atropine in the former cessation after discontinuation.

Choline-Functionalized Supramolecular Copolymers: Toward Antimicrobial Activity against Streptococcus pneumoniae.

Dynamic binding events are key to arrive at functionality in nature, and these events are often governed by electrostatic or hydrophobic interactions. Synthetic supramolecular polymers are promising candidates to obtain biomaterials that mimic this dynamicity. Here, we created four new functional monomers based on the benzene-1,3,5-tricarboxamide (BTA) motif. Choline or atropine groups were introduced to obtain functional monomers capable of competing with the cell wall of Streptococcus pneumoniae for binding of essential choline-binding proteins (CBPs). Atropine-functionalized monomers BTA-Atr and BTA-Atr3 were too hydrophobic to form homogeneous assemblies, while choline-functionalized monomers BTA-Chol and BTA-Chol3 were unable to form fibers due to charge repulsion. However, copolymerization of BTA-Chol3 with non-functionalized BTA-(OH)3 yielded dynamic fibers, similar to BTA-(OH)3. These copolymers showed an increased affinity toward CBPs compared to free choline due to multivalent effects. BTA-based supramolecular copolymers are therefore a versatile platform to design bioactive and dynamic supramolecular polymers with novel biotechnological properties.

The Impact of Clinical Atropine Use in Taiwanese Schoolchildren: Changes in Physiological Characteristics and Visual Functions.

Taiwan is commonly noted for its high prevalence of myopia, as well as a long history of more than 20 years of using atropine to control myopia. However, the clinical implications are rarely discussed. This is a cross-sectional study investigating the influence of topical atropine instillation on ocular physiology, visual function, and visual discomfort in children. Aged 7 to 12 years, 212 schoolchildren were recruited and divided into the atropine group and the non-atropine group. Physiological characteristics such as pupil size and intraocular pressure were measured, and a variety of visual functions was also evaluated. A questionnaire was used to investigate the side effects and visual complaints caused by atropine treatment. There was a significant difference in pupil size (OD: 5.40 ± 0.90 vs. 6.60 ± 1.01 mm; OS: 5.42 ± 0.87 vs. 6.64 ± 1.00 mm, p < 0.001) between the two groups. Reductions in near visual acuity, accommodation, convergence ability, and stereopsis were observed in the atropine group. The horizontal pupil diameter enlarged, and visual functions were greatly affected after administration of topical atropine. The changes in visual function during atropine therapy need to be carefully monitored by clinicians, while patient compliance is usually the key to success.

Safety and efficacy of 0.02% and 0.01% atropine on controlling myopia progression: a 2-year clinical trial

Four hundred myopic children randomly received atropine 0.02% (n = 138) or 0.01% (n = 142) in both eyes once-nightly or only wore single-vision spectacles (control group) (n = 120) for 2 years. Spherical equivalent refractive error (SER), axial length (AL), pupil diameter (PD), and amplitude of accommodation (AMP) were measured every 4 months. After 2 years, the SER changes were − 0.80 (0.52) D, − 0.93 (0.59) D and − 1.33 (0.72) D and the AL changes were 0.62 (0.29) mm, 0.72 (0.31) mm and 0.88 (0.35) mm in the 0.02% and 0.01% atropine groups and control group, respectively. There were significant differences between changes in SER and AL in the three groups (all P < 0.001). The changes in SER and AL in the 2nd year were similar to the changes in the 1st year in the three groups (all P > 0.05). From baseline to 2 years, the overall decrease in AMP and increase in PD were not significantly different in the two atropine groups, whereas the AMP and PD in the control group remained stable (all P > 0.05). 0.02% atropine had a better effect on myopia control than 0.01% atropine, and its effects on PD and AMP were similar to 0.01% atropine. 0.02% or 0.01% atropine controlled myopia progression and AL elongation synchronously and had similar effects on myopia control each year.

Myopia progression and axial elongation in Spanish children: Efficacy of atropine 0.01% eye-drops

To assess myopia progression in Spanish children and whether treatment with low-dose atropine eye drops delays myopia progression and axial elongation. 339 eyes of 339 Caucasian patients with myopia, aged 5 to 11 years, were examined. Participants were randomized to a treatment arm, receiving one atropine (0.01%) eye drop/day for two, and an untreated control arm. At the baseline and 2-year follow-up visits, we recorded: spherical equivalent (SE), axial length (AL), mean keratometry (Mean-K) and anterior chamber depth (ACD). We also examined the rate of children with higher myopia progression (change in SE >1 D/2 years) and identified risk factors for progression. In 339 eyes of the 339 children (age=7.61; SD 1.70; range 5-11 years), the mean baseline SE was-2.15 (SD 0.62) D, and AL was 24.24 (SD 0.79) mm. After 2 years, higher increases occurred in all variables except ACD in the untreated group vs. the atropine group, respectively: SE (-0.51 (SD 0.39) D vs. -0.76 (SD 0.37) D, P<0.001), AL (0.20 (SD 0.20) mm vs. 0.37 (SD 0.27) mm, P<0.001) and Mean-K (0.01 (0.28) D vs. 0.09 (0.32) D, P=0.018). Myopia progression was reduced by 32% in the treatment group. There were more progressors >1D/2y in the control group: 62/168 (36.9%) vs. 35/171 (20.5%) (P<0.001). Atropine was identified as a protective factor against myopia progression (B=1.12; 95% CI= 0.98-1.27; P=<0.001). Spanish children showed a low rate of myopia progression. Atropine 0.01% showed a significant effect in slowing the progression of both refractive error and axial elongation.

Muscarinic receptors control markers of inflammation in the small intestine of BALB/c mice

Muscarinic-acetylcholine-receptors (mAChRs) modulate intestinal homeostasis, but their role in inflammation is unclear; thus, this issue was the focus of this study. BALB/c mice were treated for 7 days with muscarine (mAChR/agonist), atropine (mAChR/antagonist) or saline. Small-intestine samples were collected for histology and cytofluorometric assays in Peyer's patches (PP) and lamina propria (LP) cell-suspensions. In LP, goblet-cells/leukocytes/neutrophils/MPO+ cells and MPO/activity were increased in the muscarine group. In PP, IFN-γ+/CD4+ T or IL-6+/CD4+ T cell numbers were higher in the muscarine or atropine groups, respectively. In LP, TNF-α+/CD4+ T cell number was higher in the muscarine group and lower in the atropine.

Orthokeratology Lenses Versus Administration of 0.01% Atropine Eye Drops for Axial Length Elongation in Children With Myopic Anisometropia.

To investigate the effect of orthokeratology (OK) lenses and that of 0.01% atropine eye drops on axial length (AL) elongation in children with myopic anisometropia. Ninety-five children with myopic anisometropia who used OK lenses (N=49) or 0.01% atropine eye drops (N=46) were enrolled in this retrospective 1-year study. For all children, the eyes with higher spherical equivalent refractive error (SER) were assigned to the H-eye subgroup, whereas the fellow eyes with lower SER were assigned to the L-eye subgroup. After 1-year treatment, the mean change in the AL of H eyes and L eyes in the OK lenses group was 0.18±0.16 mm and 0.24±0.15 mm, respectively (P=0.15), and 0.28±0.20 mm and 0.25±0.18 mm, respectively (P=0.48), in the 0.01% atropine group. Multivariate regression analyses showed significant differences in AL change between H and L eyes after treatment with OK lens (P=0.03), whereas no significant difference in the 0.01% atropine (P=0.22). The change in the AL in the H-eye group was less with OK lenses than with 0.01% atropine (P=0.04), whereas there was no significant difference between the change in AL in the L-eye group between treatment with OK lens and 0.01% atropine (P=0.89). In myopic anisometropic children, AL differences between 2 eyes decrease by wearing OK lenses but do not change after administration of 0.01% atropine eye drops. The increased effect of OK lenses, but not 0.01% atropine, in reducing axial elongation at 1 year in the eye with higher SER in anisometropic children warrants further investigation.

Influence of coronavirus disease 2019 on myopic progression in children treated with low-concentration atropine.

PurposeThe outbreak of coronavirus disease 2019 (COVID-19) has caused many children to stay indoors. Increased near work and insufficient outdoor activities are considered important risk factors for myopic progression. This study aimed to compare the changes in myopic progression before and after COVID-19 in children treated with low-concentration atropine.MethodsThe records of 103 eyes of 103 children who were treated with low-concentration atropine eye drops were retrospectively reviewed. We classified children according to the concentration of atropine eye drops and children’s age. The beginning of the pre-COVID-19 period was set from January 2019 to May 2019, and the endpoint was set in March 2020. The beginning of the post-COVID-19 period was set in March 2020, and the endpoint was set from January 2021 to March 2021. We evaluated the questionnaires administered to children’s parents.ResultsA significant myopic progression was observed in the post-COVID-19 period compared to the pre-COVID-19 period in the 0.05% and 0.025% atropine groups (P < 0.001 and P = 0.020, respectively). For children aged 5 to 7 and 8 to 10 years, the axial elongations were significantly faster in the post-COVID-19 period than in the pre-COVID-19 period (P = 0.022 and P = 0.005, respectively). However, the rates of axial elongation and myopic progression were not significantly different between pre- and post-COVID-19 in children aged 11 to 15 years (P = 0.065 and P = 0.792, respectively). The average time spent using computers and smartphones and reading time were significantly increased, and the times of physical and outdoor activity were significantly decreased in the post-COVID-19 period compared to the pre-COVID-19 period.ConclusionsThe rates of myopic progression have increased substantially after the spread of COVID-19 with an increase in the home confinement of children. Therefore, it is necessary to control the environmental risk factors for myopia, even in children undergoing treatment for the inhibition of myopic progression.

A PROSPECTIVE RANDOMISED STUDY TO ASSESS WHETHER PROPHYLACTIC ATROPINE ADMINISTRATION ATTENUATES THE NEGATIVE HAEMODYNAMIC EFFECTS OF INDUCTION OF ANAESTHESIA WITH PROPOFOL AND FENTANYL

INTRODUCTION: To provide optimal surgical conditions safely and to avoid particular complications, balanced general anaesthesia by administering a combination of propofol and fentanyl as analgesics. This type of balanced anaesthesia often induces unwanted bradycardia and hypotension, raising concerns regarding haemodynamic stability and tissue oxygenation. It is possible that atropine could replace the common clinical practice of administering vasoactive medication such as phenylephrine or norepinephrine to maintain mean arterial pressure (MAP) levels. AIM OF THE STUDY: To study the effect of atropine in suppressing the negative haemodynamic effects of induction agents- propofol and fentanyl in patients receiving general anaesthesia. MATERIALS AND METHODS: This is a prospective randomised interventional study carried out in Department of Anaesthesiology in Kanyakumari Government Medical College from January 2018 to June 2019. Patients were allocated into two groups (25 patients each) by randomization. After preoxygenation Group A: Patient receives Atropine. Patient in Group S: Receives Saline. BMI, Height, weight, Heart rate, Noninvasive blood pressure, Mean arterial pressure were recorded for every minute for 15 minutes. RESULTS: The demographic parameters like age, height, weight and BMI were similar in both groups. Comparing the SBP of both group, at base and 1 minute the difference of SBP was small. After that, the SBP was increasing trend in Atropine subjects and SBP was decreasing trend in saline subjects (P&lt;0.001). Comparing the DBP between the two groups, Base and 1 minutes, the DBP of both groups were not differed signicantly (P&gt;0.05),after that the DBP of Atropine group DBP was increasing trend and the DBP of saline group was decreasing trend (P&lt;0.001). The HR of the both groups were increasing and decreasing accordingly (P&lt;0.001). Comparing the MAP of both groups at base through 15 minutes,MAP of both group at 1minute was not differed signicantly (P&gt;0.05),after that the MAP of Atropine subjects were increasing and Saline subjects were decreasing trend P&lt;0.001). Percentage of fall of parameters (SBP, DBP, HR, and MAP) was more signicant at 5 and 15 mins compared to 10 mins in both th group. This may be due to the intubation response after the 5 minute of induction. All values were signicant with P&lt;0.001. CONCLUSION: Administration of atropine before Propofol and Fentanyl induction during general anaesthesia can signicantly attenuate the fall in Systolic Blood Pressure, Diastolic Blood Pressure, Heart Rate and Mean Arterial Pressure.

Adjunctive effects of orthokeratology and atropine 0.01% eye drops on slowing the progression of myopia

ABSTRACT Clinical relevance All eye health care practitioners should know how to control myopia. Background Investigating the adjunctive effects of orthokeratology and 0.01% atropine eye drops on controlling the progression of myopia in Chinese children. Methods The prospective study included Chinese children aged 8 to 13 years having a spherical equivalent refractive error ranging from −2.00 to −5.00 D. Participants were categorised into two groups: combination group (orthokeratology and 0.01% atropine) or atropine group (0.01% atropine). The axial length and spherical equivalent refraction were measured at baseline and every three months post-treatment and compared over two years. Results The combinaion and atropine groups comprised 20 and 22 participants. Following two years of treatment, the average spherical equivalent refraction change was 0.88 ± 0.31 D and 1.14 ± 0.63 D in the combination group and atropine group, respectively (P = 0.026), with an average increment in axial length of 0.50 ± 0.17 mm and 0.61 ± 0.21 mm, respectively (P = 0.091). In the atropine group, increased axial length was positively correlated with baseline spherical equivalent refraction (P = 0.018) and negatively correlated with baseline age (P = 0.003). However, these correlations were not observed in the combination group. In the subgroup of subjects aged 8-10 years and another subgroup of subjects with shorter initial axial length (22.00 to 24.50 mm), the changes in axial length over two years were significantly smaller in the combination group than the atropine group. Conclusion Orthokeratology and 0.01% atropine eye drops combination therapy were found to be more effective in reducing progression of myopia, as measured through spherical equivalent refraction changes, than atropine monotherapy in children over two years. Combinatorial therapy was more effective in controlling the elongation of axial length in children with younger baseline age or shorter baseline axial length.

Two-year add-on effect of using low concentration atropine in poor responders of orthokeratology in myopic children

MethodsAxial elongation in 73 eyes of 73 subjects who completed 3 years of orthokeratology (ortho-k) treatment was retrospectively reviewed. During their first year of ortho-k treatment (phase 1), they all...

Prophylactic efficacy of intravenous atropine with crystalloid co-loading for hemodynamic stability in parturient undergoing cesarean delivery at Dilla University Referral Hospital. A randomized controlled trial

BackgroundThe main objective of this study is to assess the prophylactic efficacy of intravenous atropine for the prevention of hypotension after spinal anesthesia in a parturient who underwent cesarean delivery under spinal anesthesia. MethodA randomized controlled trial study was conducted at Dilla University hospital. Pregnant women scheduled for elective cesarean section were randomized to either atropine prophylaxis (n = 33) or active prophylaxis (n = 33) for prevention of post-spinal hypotension. Sample sizes were calculated using a G-power version 3.1.9.2 getting a total of 66 participants. Intraoperative blood pressure, heart rate, and incidence of postoperative nausea and vomiting were assessed. Paired sample t-test was used to compare each group change from baseline. Independent t-test and Manny Whitney tests were used based on the distribution of data. A statistically significant difference was determined at a p-value of ≤05. ResultBoth systolic and diastolic blood pressure declined from the baseline in both groups after spinal anesthesia. Atropine didn't prevent a decline in blood pressure from the baseline during the first 60 min of initiation of spinal anesthesia (p > 0.05). Heart rates at the 15th and 20th minute were higher in the atropine group (p < 0.05). There is no statistically significant difference between groups regarding mean Apgar score, and neonatal outcome. The total crystalloid fluid given during the perioperative period is higher in the active prophylaxis group with a mean of 2151.5 ml compared to 1651.52 ml in the atropine group p = 0.002. The incidence of intraoperative nausea and vomiting was higher in the active prophylaxis group compared to the atropine group but the difference is not statistically significant p > 0.05 as it was shown in the figure below. ConclusionProphylactic administration of atropine didn't prevent a decline in blood pressure from baseline. The incidence of nausea and vomiting was lower in the atropine group with no statistically significant difference.

The Effects of 0.01% Atropine on Adult Myopes' Contrast Sensitivity.

PurposeAtropine at a low concentration is considered a safe and effective treatment to mitigate myopia progression. However, the potential unwanted side effects of administering atropine at a low dose on visual functions other than best corrected visual acuity has not been investigated. In this study, we investigate the short-term (12,16, and 20 h) and long-term (1, 2, and 4 weeks) effects of 0.01% atropine (i.e., 0.1 mg/ml) on contrast sensitivity (CS) in patients with myopia.MethodsThirty adults (23.33 ± 2.93 years old) with myopia between -1.00 and -6.00 diopters (D), astigmatism of -1.50 D or less, and anisometropia of 1.00 D or less, participated in this prospective, masked, placebo-controlled, randomized study. The participants were randomly assigned to receive 0.01% atropine or polyvinyl alcohol eye drops once nightly to both eyes for four weeks. CS was measured binocularly at baseline and 12, 16, 20 h, 1, 2, and 4 weeks after the first use of the eye drops.ResultsThere was no statistically significant differences of CS found between atropine and placebo-controlled groups in both short-term and long-term. There was no statistically significant interaction effect found between the time and group.ConclusionWe demonstrated no significant deleterious effect of 0.01% atropine on adult myopes’ CS.

Recovery of lower oesophageal barrier function: a pilot study comparing a mixture of atropine and neostigmine and sugammadex: A randomised controlled pilot study.

The lower oesophageal sphincter (LOS) barrier serves to prevent regurgitation of gastric contents. Although general anaesthesia depresses its function, its recovery process during emergence from anaesthesia has not been systematically examined. To explore whether recovery of lower oesophageal barrier function differed between patients receiving a mixture of 1 mg atropine and 2 mg neostigmine and those receiving 2 mg kg-1 sugammadex during emergence from anaesthesia. An unblinded randomised controlled pilot study. A single university hospital from January 2016 to December 2018. A total of 20 non-obese adult females undergoing minor surgery. The patients were randomly assigned to a group either receiving atropine and neostigmine or sugammadex for reversal of rocuronium. Through use of the high-resolution manometry technique, the lower oesophageal barrier pressure (PBAR: primary variable) defined as a pressure difference between pressures at the LOS and the stomach was measured at five distinguishable time points during emergence from total intravenous anaesthesia. A mixed effects model for repeated measures was used to test the hypothesis. In all patients baseline PBAR values were positive even under muscle paralysis and general anaesthesia before administration of reversal agents, and did not differ between the groups (P = 0.299). During recovery from muscle paralysis and general anaesthesia, PBAR (mean ± SD) significantly increased (P = 0.004) from 17.0 ± 2.9 to 21.0 ± 5.0 mmHg in the atropine and neostigmine group (n = 8) and from 19.1 ± 9.0 to 24.5 ± 12.7 mmHg in the sugammadex group (n = 11). PBAR significantly increased immediately after return of consciousness in both groups, whereas return of muscle tone, lightening of anaesthesia and tracheal extubation did not change it. Recovery of the lower oesophageal barrier function does not differ between patients receiving either atropine and neostigmine or sugammadex and is completed after recovery of consciousness from general anaesthesia. UMIN Clinical Trials Registry: UMIN000020500: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000023594&type=summary&language=E.

Age Effect on Treatment Responses to 0.05%, 0.025%, and 0.01% Atropine: Low-Concentration Atropine for Myopia Progression Study

To investigate the effect of age at treatment and other factors on treatment response to atropine in the Low-Concentration Atropine for Myopia Progression (LAMP) Study. Secondary analysis from a randomized trial. Three hundred fifty children aged 4 to 12 years who originally were assigned to receive 0.05%, 0.025%, or 0.01% atropine or placebo once daily, and who completed 2 years of the LAMP Study, were included. In the second year, the placebo group was switched to the 0.05% atropine group. Potential predictive factors for change in spherical equivalent (SE) and axial length (AL) over 2 years were evaluated by generalized estimating equations in each treatment group. Evaluated factors included age at treatment, gender, baseline refraction, parental myopia, time outdoors, diopter hours of near work, and treatment compliance. Estimated mean values and 95% confidence intervals (CIs) of change in SE and AL over 2 years also were generated. Factors associated with SE change and AL change over 2 years were the primary outcome measures. Associated factors during the first year were secondary outcome measures. In 0.05%, 0.025%, and 0.01% atropine groups, younger age was the only factor associated with SE progression (coefficient of 0.14, 0.15, and 0.20, respectively) and AL elongation (coefficient of -0.10, -0.11, and -0.12, respectively) over 2 years; the younger the age, the poorer the response. At each year of age from 4 to 12 years across the treatment groups, higher-concentration atropine showed a better treatment response, followinga concentration-dependent effect (Ptrend <0.05 for each age group). In addition, the mean SE progression in 6-year-old children receiving 0.05% atropine (-0.90 diopter [D]; 95% CI, -0.99 to -0.82) was similar to that of 8-year-old children receiving 0.025% atropine (-0.89 D; 95% CI, -0.94 to -0.83) and 10-year-old children receiving 0.01% atropine (-0.92 D; 95% CI, -0.99 to -0.85). All concentrations were well tolerated in all age groups. Younger age is associated with poor treatment response to low-concentration atropine at 0.05%, 0.025%, and 0.01%. Among concentrations studied, younger children required the highest 0.05% concentration to achieve similar reduction in myopic progression as older children receiving lower concentrations.

Topical atropine in retarding myopia progression and axial length growth in children with myopia

This study was conducted to observe the effect of atropine in retarding myopia progression and axial length growth in 36 myopic children (atropine group, 24; control, 12). The initial spherical equivalent of the atropine group and control group was -3.0 ± 1.6 dioptre and -3.5 ± 1.6 dioptre respectively. At the 12th month in atropine group, it was -2.9 ± 2.6 dioptre and -4.6 ± 1.9 dioptre in the control group. The power of the atropine group reduced but rose in the control group after 12 months. There was a statistically significant difference in final refractive errors between the two groups (p&lt;0.05). The initial axial length of the atropine group and control group was 24.3± 1.0 mm and 24.6 ± 1.1 mm respectively. In 12th month, the changes in axial length in the two groups was insignificant. However, the mean axial length progression at 12 months of the atropine group was -0.1 ± 0.1 mm and it was lower than the control group which was -0.2 ± 0.2 mm, and this was statistically significant (p&lt;0.05). In conclusion, topical atropine (0.01%) retarded myopia progre-ssion and axial length growth in myopic children.