Tran Huy D M, Tran Yen H, Ha Thao T X, Tran Tuan D, Jong Monica, Coroneo Minas, Sankaridurg Padmaja
University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam; Hai Yen Vision Institute, Ho Chi Minh City, Vietnam; Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
Hai Yen Vision Institute, Ho Chi Minh City, Vietnam; Department of Ophthalmology, An Sinh Hospital, Ho Chi Minh City, Vietnam.
Asia Pac J Ophthalmol (Phila). 2025 Jan-Feb;14(1):100138. doi: 10.1016/j.apjo.2025.100138. Epub 2025 Jan 15.
To determine the role of topical caffeine in slowing progression of myopia, both as a standalone treatment and in combination with atropine.
In a prospective, randomized, dispensing clinical trial, 96 children with myopia, aged 6-13 years, spherical equivalent (SE) from -0.50 diopters (D) to -6.00 D and astigmatism less than 2.00 D were randomly assigned to nightly use of either 2 % caffeine, 0.02 % atropine with 2 % caffeine (combination) or 0.02 % atropine eye drops. An additional 86 children with myopia were enrolled in a concurrent parallel group to wear single-vision (SV) spectacles. The primary outcomes were changes in SE and axial length (AL) over a period of 12 months for each group.
All groups progressed in myopia. At 12 months, the mean change in SE/AL was -0.76 ± 0.51 D / 0.37 ± 0.20 mm and -0.70 ± 0.55 D / 0.35 ± 0.23 mm with SV and 2 % caffeine, respectively. In comparison, progression was slower at -0.46 ± 0.50 D / 0.24 ± 0.19 mm and -0.47 ± 0.38 D / 0.23 ± 0.18 mm with atropine monotherapy and combination groups, respectively. Compared to the change in AL with SV, the change in AL was significantly less with 0.02 % atropine and the combination group (post hoc analysis, P = 0.024 and 0.007, respectively). Similarly, the change in SE was significantly less with 0.02 % atropine compared to the SV group (P = 0.027).
Used as a standalone treatment, topical 2 % caffeine did not slow myopia progression. When combined with atropine, caffeine had no impact on the efficacy of atropine in slowing myopia.
确定局部使用咖啡因作为单一治疗方法以及与阿托品联合使用时在减缓近视进展中的作用。
在一项前瞻性、随机、配药临床试验中，96名6至13岁近视儿童，等效球镜度（SE）为-0.50屈光度（D）至-6.00 D且散光小于2.00 D，被随机分配为每晚使用2%咖啡因、0.02%阿托品与2%咖啡因（联合用药）或0.02%阿托品滴眼液。另外86名近视儿童被纳入同期平行组佩戴单焦点（SV）眼镜。主要结局是每组在12个月期间SE和眼轴长度（AL）的变化。
所有组近视均有进展。12个月时，佩戴SV眼镜组和2%咖啡因组的SE/AL平均变化分别为-0.76±0.51 D / 0.37±0.20 mm和-0.70±0.55 D / 0.35±0.23 mm。相比之下，阿托品单药治疗组和联合用药组进展较慢，分别为-0.46±0.50 D / 0.24±0.19 mm和-0.47±0.38 D / 0.23±0.18 mm。与佩戴SV眼镜组的AL变化相比，0.02%阿托品组和联合用药组的AL变化显著更小（事后分析，P分别为0.024和0.007）。同样，与SV眼镜组相比，0.02%阿托品组的SE变化显著更小（P = 0.027）。
作为单一治疗方法使用时，局部2%咖啡因并未减缓近视进展。与阿托品联合使用时，咖啡因对阿托品减缓近视的疗效无影响。
