Spherical Equivalent Progression Research Articles

EFFICACY OF ATROPINE SULPHATE EYE DROPS IN CONTROLLING MYOPIA PROGRESSION: A REVIEW

Introduction: Myopia is major public health concern that has become increasingly common. Severe myopia has become one of the main causes of untreatable vision loss throughout the world, often due to its irreversible complications. Studies shows atropine can reduce myopia progression in children. Currently, there are no guidelines for the use of atropine specifically to control myopia progression. This study was made to review the efficacy of various atropine doses in controlling myopia progression. Methods: Literature searching was conducted in four online databases (PubMed, EBSCOhost, ScienceDirect, and Scopus. Search terms included were “Atropine” and “Myopia”. Validity was assessed using assessment tool from Cochrane. Efficacy was evaluated using myopia progression in spherical equivalent per year and axial lengthening per year. Results: Sixteen randomized controlled trial studies fulfilled our inclusion criteria and eligibility screening. Overall, atropine shows favorable results in spherical equivalent progression (D/year) compared to control, with SMD = -1.13, 95% CI (-0.58, -1.68). Less axial elongation (mm/year) was observed in atropine group, with SMD = -1.28, 95% CI (-0.18, -2.37). Atropine 0.01% concentration shows overall significantly better myopia progression and axial lengthening compared to control, with SMD = -0.76, 95% CI (-0.08, -1.44) and SMD = -0.63, 95% CI (-0.14, -1.12), respectively. Higher atropine doses showed larger effect sizes with higher occurrence of adverse effects. Conclusion: Atropine eye drops in various doses shows overall effective myopia control in spherical equivalent and axial lengthening. Atropine 0.01% has significant myopia progression inhibition with less adverse effects than higher doses.

Short-term effect of 0.01% atropine sulphate eye gel on myopia progression in children.

To investigate the effect of 0.01% atropine sulphate eye gel on myopia progression and axial elongation in a 6-month treatment in children. Totally 185 children aged 6-12y with binocular myopia of 3.0 D or less in both eyes were enrolled in this prospective cohort study. The atropine group (n=125) received one drop of 0.01% atropine sulphate eye gel in each eye before bedtime daily. The control group included 60 matched children without drug intervention during the same period. The spherical equivalent and axial length was recorded at baseline and the sixth month of treatment. The efficacy was evaluated by the change of the spherical equivalent and axial length. Adverse events were also recorded. The average spherical equivalent and axial length at baseline were not statistically significant between the atropine group (-1.64±0.80 D, 24.13±0.76 mm) and the control group (-1.59±0.94 D, 24.06±0.77 mm, P>0.05). After 6mo, there was significantly difference in the spherical equivalent progression between the atropine and the control group (-0.27±0.33 vs -0.60±0.35 D, P<0.001), with a relative reduction of 55.0% in myopia progression. The increase in axial elongation in the atropine group was significantly less than control group (0.19±0.14 vs 0.26±0.14 mm, P<0.001), with a relative reduction of 26.9% in axial length. The 84.4% and 38.4% of the eyes progressed by less than 0.50 D and remained stable in the atropine group, compared with 51.7% and 4.2% in the control group. No adverse events were observed. Atropine sulphate eye gel 0.01% can slow down myopia progression and axial elongation in children with a 6-month treatment.

Association between axial length elongation and spherical equivalent progression in Chinese children and adolescents.

It is generally believed that a 1-mm axial length (AL) elongation of the eye corresponds to a -3.00 D spherical equivalent (SE) progression, but this is disputed. To investigate the association between AL elongation and SE progression among children and adolescents. A prospective cohort study of 710 children and adolescents aged 6-16 years was included. Ophthalmic examinations, including cycloplegic SE, AL and corneal curvature, were performed at baseline and 1-year follow-up. The ratio of SE change (ΔSE) to AL change (ΔAL) (ΔSE/ΔAL) was calculated, and its association with age and refractive status was explored using a general linear model. Among all participants, 396 (55.77%) were male, with 265 (37.32%) myopes at baseline. The average 1-year ΔSE and ΔAL were 0.61 ± 0.40 D and 0.33 ± 0.22 mm, respectively. Both ΔSE and ΔAL gradually decreased with age (p < 0.001). In the general linear model analyses, age and refractive status were independently associated with ΔSE/ΔAL after adjustment for covariates (age: =0.04, p < 0.05; myopia vs nonmyopia: =0.28, p < 0.05). Based on the developed formula ΔSE/ΔAL=1.74 + 0.05*age (for myopes), mean ΔSE/ΔAL in myopes increased from 2.06 D/mm in the 6-year-olds to 2.59 D/mm in the 16-year-olds. In nonmyopes, ΔSE/ΔAL=1.33 + 0.05*age, and the ratio increased from 1.65 D/mm in the 6-year-olds to 2.18 D/mm in the 16-year-olds. The ratio of ΔSE/ΔAL varied with age and refractive status in children and adolescents. The age-specific ΔSE/ΔAL could be used to estimate SE progression through the actual AL change.