Kumari Shalini, Anand Raj, Tripathi Shashank, Mishra Rajesh C, Jha Simant Kumar
Ophthalmology, Al Falah School of Medical Sciences and Research Centre, Faridabad, Haryana, India.
Ophthalmology, Eye 7 Hospital, New Delhi, India.
J Family Med Prim Care. 2022 Nov;11(11):6668-6677. doi: 10.4103/jfmpc.jfmpc_1339_22. Epub 2022 Dec 16.
To conduct a meta-analysis of randomized controlled trials (RCTs) on the effects of atropine eye drop in slowing myopia progression.
A systematic search of relevant articles was done through a computerized search on PubMed, Medline, Cochrane Library, and Google Scholar on June 16, 2022. A supplementary search was done on on the same date. After thorough search and analysis, seven relevant RCTs, double-masked with atropine eye drop as intervention arm and placebo as control arm, were selected for meta-analysis. Jadad scoring was used to evaluate the quality of RCTs. The outcome measurements included in the present meta-analysis are mean changes in the spherical equivalent (SE) of myopic error, and mean changes in axial length (AL) during the study period.
Pooled summary effect size, calculated by random effect model, for SE of myopia progression was 1.08 with 95% confidence interval (CI) (0.31-1.86) which was statistically significant (-value = 0.006). Pooled summary effect size, calculated by random effect model, for axial length was - 0.89 with 95% CI (-1.48 to - 0.30) which was statistically significant (-value = 0.003).
In summary, atropine was demonstrated to be effective in controlling myopia progression in children. Both outcome measures, mean SE changes and mean AL elongation responded to atropine intervention compared to placebo.
对随机对照试验（RCT）进行荟萃分析，以研究阿托品滴眼液对减缓近视进展的效果。
于2022年6月16日通过计算机检索PubMed、Medline、Cochrane图书馆和谷歌学术等数据库，对相关文章进行系统检索。同日进行了补充检索。经过全面检索和分析，选择了7项相关的随机对照试验进行荟萃分析，试验采用双盲设计，干预组使用阿托品滴眼液，对照组使用安慰剂。采用Jadad评分法评估随机对照试验的质量。本次荟萃分析纳入的结局指标包括近视屈光度等效球镜度（SE）的平均变化以及研究期间眼轴长度（AL）的平均变化。
采用随机效应模型计算的近视进展SE的合并汇总效应量为1.08，95%置信区间（CI）为（0.31 - 1.86），具有统计学意义（P值 = 0.006）。采用随机效应模型计算的眼轴长度合并汇总效应量为 - 0.89，95%CI为（-1.48至 - 0.30），具有统计学意义（P值 = 0.003）。
综上所述，阿托品被证明对控制儿童近视进展有效。与安慰剂相比，两个结局指标，即平均SE变化和平均AL伸长均对阿托品干预有反应。
