Anders Lisa-Marie, Heinrich Sven P, Lagrèze Wolf A, Joachimsen Lutz
Eye Center, Medical Center, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Doc Ophthalmol. 2019 Apr;138(2):85-95. doi: 10.1007/s10633-019-09671-0. Epub 2019 Jan 24.
Daily administration of 0.01% atropine eye drops is a promising approach for myopia control. The mechanism of action is believed to involve the dopaminergic system of the retina, triggering an increased release of dopamine. Previous studies in psychiatric condition such as major depression suggest that pattern electroretinogram (PERG) amplitudes are modulated by changes in retinal dopamine. It is thus plausible that atropine eye drops could have an effect on PERG amplitudes. The present study was designed to test this, assessing the difference in amplitude between contrast levels and the ratio of amplitudes between check sizes as primary endpoints.
We included 14 participants with no more than ± 2 diopters of ametropia and visual acuity of at least 1.0. One eye was chosen randomly in each participant for atropine application (14 days, one drop of 0.01% atropine solution once daily before bedtime). We recorded two sets of steady-state PERG recordings: one with different contrasts (25% and 98%) and one with different check sizes (0.8° and 17°). Near-point distance, near visual acuity, and pupil diameter were measured additionally.
The recordings to different contrasts did not show atropine-related changes of PERG amplitude. A small increase by 6% of the amplitude difference between contrast levels with atropine application was not significant (p = 0.08). Raw amplitudes in the check size condition increased with atropine by 17% (p < 0.01) and 10% (p < 0.03) for small and large checks, respectively, without a significant concomitant effect on the amplitude ratio. Pupil size was significantly affected (median increase 0.5 mm, p < 0.002). However, neither of the experimental conditions was associated with a significant correlation between pupil size and PERG effects.
The effects on PERG primary endpoints after the 14-day period of atropine administration were small, especially compared to effect sizes in major depression, and statistically insignificant. Effects on raw amplitude were inconsistent. The present results suggest that retinal processing as reflected by PERG does not sizably change following a treatment regimen with atropine that is typical for myopia control.
每日使用0.01%阿托品滴眼液是一种很有前景的控制近视的方法。其作用机制被认为涉及视网膜的多巴胺能系统，从而引发多巴胺释放增加。先前针对重度抑郁症等精神疾病的研究表明，图形视网膜电图（PERG）振幅会受到视网膜多巴胺变化的调节。因此，阿托品滴眼液可能会对PERG振幅产生影响，这似乎是合理的。本研究旨在对此进行测试，将不同对比度水平下的振幅差异以及不同方格大小间的振幅比值作为主要终点进行评估。
我们纳入了14名屈光不正不超过±2屈光度且视力至少为1.0的参与者。在每位参与者中随机选择一只眼睛使用阿托品（为期14天，每天睡前滴一滴0.01%阿托品溶液）。我们记录了两组稳态PERG记录：一组采用不同对比度（25%和98%），另一组采用不同方格大小（0.8°和17°）。此外，还测量了近点距离、近视力和瞳孔直径。
不同对比度下的记录未显示出与阿托品相关的PERG振幅变化。使用阿托品后，对比度水平间的振幅差异小幅增加了6%，但不显著（p = 0.08）。在方格大小条件下，使用阿托品后，小方格和大方格的原始振幅分别增加了17%（p < 0.01）和10%（p < 0.03），且对振幅比值没有显著的伴随影响。瞳孔大小受到显著影响（中位数增加0.5毫米，p < 0.002）。然而，两种实验条件均未显示瞳孔大小与PERG效应之间存在显著相关性。
阿托品给药14天后对PERG主要终点的影响较小，尤其是与重度抑郁症中的效应大小相比，且在统计学上不显著。对原始振幅的影响并不一致。目前的结果表明，在采用典型的用于控制近视的阿托品治疗方案后，PERG所反映的视网膜加工过程没有显著变化。
