Jeon Gang Seok, Hong In Hwan, Lee Jang Hun, Song Tae Geun, Lee Tae Yeem, Han Jae Ryong
Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Korea.
Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Gyeonggi, Korea.
Eur J Ophthalmol. 2022 Jul;32(4):2011-2017. doi: 10.1177/11206721211038817. Epub 2021 Aug 16.
Myopia usually commences during primary school and progresses until the mean age of 16 years. Topical low-dose (0.01%) atropine eye-drop appears to be safe and efficacious for myopia control in children. However, in some cases, a higher concentration of atropine is required in some cases because low-dose atropine treatment is not effective.
This is a retrospective study among young myopic children between 5 and 15 years with myopia progression > 0.50 D/year. We selected patients treated with low-dose atropine (0.01%) eye-drops for 12 months and conducted a comparative analysis of the group with good responder and poor responder. Patients were classified as good responders if spherical equivalent refractive error (SE) progression was ⩽ 0.50 D after 12 months of treatment and poor responders if SE progression > 0.50 D. The prognostic factors before and after treatment were analyzed in two groups.
A total of 68 eyes were included. Low-dose (0.01%) atropine eye-drops have a good treatment response in 54% of patients. In the good responder group ( = 37), the mean rate of myopia progression after 12 months of treatment (0.36 ± 0.17 D) was significantly slower compared with the baseline progression ( < 0.001). Good responders have smaller changes in axial length (AL) elongation and SE than poor responders ( < 0.001). The only adverse event was temporary near vision difficulty (10%), photophobia (10%), and mild pupil dilation (30%).
The AL elongation is an important indicator for monitoring the treatment response. Children with a family history of myopia at a young age may not respond well to low-dose (0.01%) atropine eye-drops. In these cases, increasing the concentration of atropine eye-drops should be considered.
近视通常始于小学阶段，并持续发展至平均16岁。局部低剂量（0.01%）阿托品滴眼液似乎对儿童近视控制安全有效。然而，在某些情况下，由于低剂量阿托品治疗无效，需要更高浓度的阿托品。
这是一项针对5至15岁近视进展>0.50 D/年的年轻近视儿童的回顾性研究。我们选择接受低剂量（0.01%）阿托品滴眼液治疗12个月的患者，并对反应良好组和反应不佳组进行比较分析。如果治疗12个月后球镜等效屈光不正（SE）进展≤0.50 D，则患者被分类为反应良好者；如果SE进展>0.50 D，则为反应不佳者。分析两组治疗前后的预后因素。
共纳入68只眼。低剂量（0.01%）阿托品滴眼液在54%的患者中具有良好的治疗反应。在反应良好组（n = 37）中，治疗12个月后的平均近视进展率（0.36±0.17 D）与基线进展相比显著减慢（P<0.001）。反应良好者的眼轴长度（AL）伸长和SE变化比反应不佳者小（P<0.001）。唯一的不良事件是暂时性近视力困难（10%）、畏光（10%）和轻度瞳孔散大（30%）。
AL伸长是监测治疗反应的重要指标。年轻时有近视家族史的儿童可能对低剂量（0.01%）阿托品滴眼液反应不佳。在这些情况下，应考虑增加阿托品滴眼液的浓度。
