Rajavi Zhale, Kheiri Bahareh, Sheibani Kourosh, Sabbaghi Hamideh
Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Curr Ophthalmol. 2024 Oct 16;36(1):82-88. doi: 10.4103/joco.joco_344_22. eCollection 2024 Jan-Mar.
To determine myopic progression, axial length elongation, best-corrected visual acuity (BCVA), pupil dilation, and accommodation amplitude following 24 months of Atropine 0.01% usage among progressive myopic patients.
Fifty-one progressive myopic patients (age range, 3.5-17 years) were included in the present study. Fifteen patients were excluded due to loss to follow-up (eight patients) and Atropine complications (seven patients) and 36 patients continued therapy. Myopic progression, axial length, far and near BCVA, pupil diameter, and accommodation amplitude were measured at baseline examination and repeated every 6 months up to 2 years. All patients were recommended to instill one drop of Atropine 0.01% in each eye every night. Absolute success of therapy was defined as myopic progression ≤0.50 diopter (D) and axial length growth ≤0.2 mm per year.
Mean myopic progression was 0.16 and 1.28 D and mean axial length change was 0.05 and 0.69 mm at months 12 and 24, respectively. Pupil dilation was 1.26 and 1.84 mm and accommodation reduction was 3.38 and 3.37 D at the same follow-ups, while BCVA was not changed. Absolute success rate for myopic progression control was 56.8% at 12 months and 70.8% at 24 months follow-up. In addition, the success rate in respect to axial length changes was 44.4% and 58.3% at the same time points.
Atropine 0.01% can slow myopic progression and axial length elongation at least in 50% of myopic cases at 12- and 24-month follow-up with no significant complications. Therefore, Atropine therapy is recommended in cases of progressive myopia in children and teenagers.
确定0.01%阿托品治疗24个月后进展性近视患者的近视进展、眼轴长度延长、最佳矫正视力（BCVA）、瞳孔散大及调节幅度。
本研究纳入51例进展性近视患者（年龄范围3.5 - 17岁）。15例患者因失访（8例）和阿托品并发症（7例）被排除，36例患者继续治疗。在基线检查时测量近视进展、眼轴长度、远近视力、瞳孔直径和调节幅度，并每6个月重复测量一次，直至2年。所有患者被建议每晚每眼滴一滴0.01%阿托品。治疗的绝对成功定义为近视进展≤0.50屈光度（D）且眼轴长度每年增长≤0.2毫米。
在第12个月和第24个月时，平均近视进展分别为0.16 D和1.28 D，平均眼轴长度变化分别为0.05毫米和0.69毫米。在相同随访时，瞳孔散大分别为1.26毫米和1.84毫米，调节幅度降低分别为3.38 D和3.37 D，而BCVA未改变。近视进展控制的绝对成功率在12个月时为56.8%，在24个月随访时为70.8%。此外，在相同时间点，眼轴长度变化的成功率分别为44.4%和58.3%。
在12个月和24个月随访时，0.01%阿托品至少能使50%的近视病例减缓近视进展和眼轴长度延长，且无明显并发症。因此，对于儿童和青少年的进展性近视病例，推荐阿托品治疗。
