Kumaran Arjunan, Htoon Hla M, Tan Donald, Chia Audrey
Yong Loo Lin School of Medicine National University of Singapore, Singapore.
Singapore Eye Research Institute, Singapore.
Invest Ophthalmol Vis Sci. 2015 Aug;56(9):5650-5. doi: 10.1167/iovs.14-14716.
To analyze changes in refraction and associated biometric changes in atropine- and placebo-treated eyes in the Atropine for Treatment of Myopia study (ATOM1).
A total of 400 myopic children, aged 6 to 12 years, were assigned randomly to receive 1% atropine or a placebo agent in one eye daily for 2 years, after which drops were stopped and children monitored for another year. Cycloplegic autorefraction, A-scan biometry, and automated keratometry were performed at the initial visit, 2 weeks (baseline), and at 4, 8, 12, 16, 20, 24, 30, and 36 months.
A total of 313 children (78.3%) completed the study. In placebo-treated eyes, there was myopic progression of -1.55 diopters (D), between baseline and 36 months, associated with reductions in corneal curvature (K; -0.13 D) and anterior chamber depth (ACD; -0.17 mm) and increases in lens thickness (LT; 0.05 mm), vitreous chamber depth (VCD; 0.65 mm), and axial length (AL; 0.53 mm). Multivariate analysis of change in spherical equivalent demonstrated that the hyperopic shift (0.20 D) noted in atropine-treated eyes between baseline and 4 months, and the myopic rebound (-0.74 D) noted between 24 to 30 months when atropine was stopped, were associated with a reduction and increase in VCD and AL, respectively, after adjusting for age and sex. Changes in K, ACD, and LT were less relevant. Between 4 and 24 months, atropine-treated eyes demonstrated gradual myopic progression (-0.40 D), accompanied by reduction in K (-0.06 D) and ACD (-0.07 mm) and increase in VCD (0.13 mm) and AL (0.06 mm).
Atropine appeared to slow myopia progression mainly by reducing or slowing the growth in VCD, and thereby AL. (ClinicalTrials.gov number, NCT00371124.)
在阿托品治疗近视研究（ATOM1）中，分析阿托品治疗眼和安慰剂治疗眼的屈光变化及相关生物测量变化。
共有400名6至12岁的近视儿童被随机分配，一只眼睛每日接受1%阿托品或安慰剂治疗，持续2年，之后停药并对儿童再监测1年。在初次就诊、2周（基线）以及4、8、12、16、20、24、30和36个月时进行睫状肌麻痹自动验光、A超生物测量和自动角膜曲率测量。
共有313名儿童（78.3%）完成了研究。在安慰剂治疗眼中，从基线到36个月近视进展为-1.55屈光度（D），伴有角膜曲率（K；-0.13 D）和前房深度（ACD；-0.17 mm）降低，晶状体厚度（LT；0.05 mm）、玻璃体腔深度（VCD；0.65 mm）和眼轴长度（AL；0.53 mm）增加。等效球镜度变化的多变量分析表明，在调整年龄和性别后，阿托品治疗眼在基线至4个月时出现的远视漂移（0.20 D）以及在停用阿托品后24至30个月时出现的近视反弹（-0.74 D），分别与VCD和AL的减少和增加有关。K、ACD和LT的变化相关性较小。在4至24个月期间，阿托品治疗眼表现出逐渐的近视进展（-0.40 D），伴有K（-0.06 D）和ACD（-0.07 mm）降低以及VCD（0.13 mm）和AL（0.06 mm）增加。
阿托品似乎主要通过减少或减缓VCD的增长，进而减缓AL的增长来延缓近视进展。（临床试验.gov编号，NCT00371124。）
