Changes of refractive errors in children with different initial predicted myopia progression rates after 6-month 0.01% atropine treatment

Abstract

Purpose : To investigate the 6-month treatment effect of 0.01% atropine on myopic changes in children with different initial predicted myopia progression rates (PMPR) measured by global flash multifocal ERG (mfERG) Methods : 24 children aged 8 to 9 years were randomly assigned to the treatment group (T, n=12) of 0.01% atropine and the control group (C, n=12) of artificial tears. Cycloplegic objective refraction (SER), axial length (AL) measurement and mfERG were performed at baseline and after 6 months of daily treatment. Central mfERG response from the tested eye of each subject at baseline was analyzed to determine the PMPR according to our previous study (DOI:10.1167/iovs.16-21279). The changes in refractive errors and axial length of the tested eye were calculated and compared within group and between groups by Mann-Whitney U test. Results : After 6-month atropine treatment, group T showed a mean change of -0.12D in SER and 0.15mm in AL, while group C had a change of -0.44D and 0.21mm. There was a significant difference in SER between groups (p=0.03). There were 4 and 8 subjects with slow and fast PMPR respectively in group T; while 3 and 9 subjects with slow and fast PMPR respectively in group C. Those with slow PMPR in group T and C showed similar mean change of myopia progression (T: DSER=-0.31D; DAL=0.18mm; C: DSER=-0.33D; DAL=0.21mm). However, those with fast PMPR in group T showed a significant less myopia change as compared those in group C (T: DSER=-0.06D; DAL=0.18mm; C: DSER=-0.47D; DAL=0.22mm, p=0.02 for SER). Conclusions : The 6-month 0.01% atropine treatment was shown to be effective in reducing myopia progression for the children who have fast PMPR measured by mfERG, but not for those who had slow predicted rate.