University of Western Australia, Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), Perth, Western Australia, Australia.
https://orcid.org/0000-0001-6635-1098.
Invest Ophthalmol Vis Sci. 2024 Aug 1;65(10):21. doi: 10.1167/iovs.65.10.21.
Few studies have explored choroidal changes after cessation of myopia control. This study evaluated the choroidal thickness (ChT) and choroidal vascularity index (CVI) during and after discontinuing long-term low-concentration atropine eye drops use for myopia control.
Children with progressive myopia (6-16 years; n = 153) were randomized to receive 0.01% atropine eye drops or a placebo (2:1 ratio) instilled daily over 2 years, followed by a 1-year washout (no eye drop use). Optical coherence tomography imaging of the choroid was conducted at the baseline, 2-year (end of treatment phase), and 3-year (end of washout phase) visits. The main outcome measure was the subfoveal ChT. Secondary measures include the CVI.
During the treatment phase, the subfoveal choroids in both treatment and control groups thickened by 12-14 µm (group difference P = 0.56). During the washout phase, the subfoveal choroids in the placebo group continued to thicken by 6.6 µm (95% confidence interval [CI] = 1.7 to 11.6), but those in the atropine group did not change (estimate = -0.04 µm; 95% CI = -3.2 to 3.1). Participants with good axial eye growth control had greater choroidal thickening than the fast-progressors during the treatment phase regardless of the treatment group (P < 0.001), but choroidal thickening in the atropine group's fast-progressors was not sustained after stopping eye drops. CVI decreased in both groups during the treatment phase, but increased in the placebo group after treatment cessation.
On average, compared to placebo, 0.01% atropine eye drop treatment did not cause a differential rate of change in ChT during treatment, but abrupt cessation of long-term 0.01% atropine eye drops may disrupt normal choroidal thickening in children.
鲜有研究探讨近视控制停止后脉络膜的变化。本研究评估了长期使用低浓度阿托品治疗近视停止后脉络膜厚度（ChT）和脉络膜血管指数（CVI）的变化。
6-16 岁进展性近视儿童（n=153）被随机分为接受 0.01%阿托品滴眼液或安慰剂（2:1 比例）每日滴眼 2 年，随后 1 年洗脱期（不滴用眼药水）。在基线、2 年（治疗结束时）和 3 年（洗脱结束时）访视时进行脉络膜光学相干断层扫描成像。主要观察指标为中心凹下脉络膜厚度。次要观察指标包括脉络膜血管指数。
治疗期间，治疗组和对照组中心凹下脉络膜均增厚 12-14 µm（组间差异 P=0.56）。洗脱期间，安慰剂组中心凹下脉络膜继续增厚 6.6 µm（95%置信区间 [CI] = 1.7 至 11.6），而阿托品组无变化（估计值=-0.04 µm；95% CI = -3.2 至 3.1）。无论治疗组如何，轴向眼轴增长控制良好的患者在治疗期间脉络膜增厚程度均大于快速进展者（P<0.001），但阿托品组快速进展者停药后脉络膜增厚并未持续。两组在治疗期间 CVI 均降低，但治疗停止后安慰剂组 CVI 增加。
与安慰剂相比，0.01%阿托品滴眼液治疗平均在治疗期间不会导致 ChT 变化率的差异，但长期使用 0.01%阿托品滴眼液的突然停药可能会干扰儿童脉络膜的正常增厚。
