PLoS ONE (Jan 2021)

Use baseline axial length measurements in myopic patients to predict the control of myopia with and without atropine 0.01.

  • Loreto V T Rose,
  • Angela M Schulz,
  • Stuart L Graham

DOI
https://doi.org/10.1371/journal.pone.0254061
Journal volume & issue
Vol. 16, no. 7
p. e0254061

Abstract

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PurposeIdentifying axial length growth rate as an indicator of fast progression before initiating atropine 0.01% for myopia progression in children.MethodFrom baseline, axial length growth over six months was measured prospectively. Subjects were then initiated on atropine 0.01% if axial length growth was greater than 0.1mm per 6 months (fast progressors), axial length and spherical equivalent change measurements recorded every six months. The rate of change was compared to the baseline pre-treatment rate. If axial length change was below the threshold, subjects received monitoring only.Results73 subjects were identified as fast progressors and commenced atropine 0.01%, (mean baseline refraction of OD -2.9±1.6, OS -2.9±1.8 and a mean baseline axial length OD 24.62 ± 1.00 mm, OS 24.53 ± 0.99 mm). At six months, the mean paired difference of axial length growth rate was significantly reduced by 50% of baseline (all 73 subjects, pConclusionIdentifying fast progressors before treatment initiation demonstrated a strong treatment effect with atropine 0.01% reducing their individual rate of myopia progression by 50%. Another large group of myopic children, slow progressors, continued without medical intervention. A baseline axial length growth rate is proposed as a guideline to identify fast progressors who are more likely to benefit from atropine 0.01%.