Loughman James, Flitcroft D I
Department of Optometry, School of Physics, College of Sciences & Health, Dublin Institute of Technology, Dublin, Ireland.
Faculty of Health Sciences, African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa.
Br J Ophthalmol. 2016 Nov;100(11):1525-1529. doi: 10.1136/bjophthalmol-2015-307861. Epub 2016 Feb 22.
Myopia is a condition of enormous public health concern, affecting up to 2.5 billion people worldwide. The most effective treatment to prevent myopia progression is atropine but at the cost of accommodative paresis and mydriasis, necessitating the use of bifocal glasses. Low-dose atropine (0.01%) has been found to be almost as effective with significantly reduced side effects. Since there are well-recognised differences in the effect of atropine between heavily pigmented Asian eyes and Caucasian eyes, this study aimed to determine the acceptability and tolerability of 0.01% atropine (by measuring visual performance and quality of life) as a treatment for myopia control in a Caucasian population exhibiting light irides.
14 university students aged 18-27 were recruited to the study. Participants received one drop of 0.01% atropine daily into each eye over 5 days. A range of physiological, functional and quality of life measures were assessed at baseline, day 3 and day 5.
The effect of atropine was statistically significant for pupil size (p=0.04) and responsiveness (p<0.01). While amplitude of accommodation reduced, the change was not statistically significant. Visual acuity (distance and near) and reading speed were not adversely affected. While there was a slight increase in symptoms such as glare, overall there was no quality of life impact associated with the use of low-dose atropine.
Overall, 0.01% of atropine was generally well tolerated bilaterally and no serious adverse effects were observed. Therefore this dose appears to provide a viable therapeutic option for myopia control among Caucasian eyes.
近视是一个备受公众健康关注的问题,全球多达25亿人受其影响。预防近视进展最有效的治疗方法是阿托品,但代价是调节麻痹和瞳孔散大,因此需要佩戴双焦点眼镜。已发现低剂量阿托品(0.01%)几乎同样有效,且副作用显著减少。由于深色素沉着的亚洲眼睛和白种人眼睛对阿托品的反应存在公认的差异,本研究旨在确定0.01%阿托品在虹膜颜色浅的白种人群体中作为控制近视治疗方法的可接受性和耐受性(通过测量视觉表现和生活质量)。
招募了14名年龄在18 - 27岁的大学生参与研究。参与者在5天内每天每只眼睛滴入一滴0.01%阿托品。在基线、第3天和第5天评估了一系列生理、功能和生活质量指标。
阿托品对瞳孔大小(p = 0.04)和反应性(p < 0.01)的影响具有统计学意义。虽然调节幅度降低,但变化无统计学意义。视力(远视力和近视力)和阅读速度未受到不利影响。虽然眩光等症状略有增加,但总体而言,使用低剂量阿托品对生活质量没有影响。
总体而言,0.01%阿托品双侧耐受性良好,未观察到严重不良反应。因此,该剂量似乎为白种人眼睛的近视控制提供了一种可行的治疗选择。