Private Practice Experience with Low-Dose Atropine for the Treatment of Progressive Myopia
Noha S. Ekdawi, MD; Michael A. Kipp, MD
Wheaton Eye Clinic
Introduction: Progressive myopia is associated with multiple sight-threatening conditions1- 2. We retrospectively reviewed patients’ charts on low-dose atropine from 2012 to present.
Methods: All patients’ charts offered atropine where retrospectively reviewed from February 1, 2012 to November 30, 2016. Two cycloplegic refractions at least 12 months apart was the inclusion criteria. All statistical analysis was conducted via paired t-test.
Results: Of the 51 patients identified, 30 met criteria for inclusion. Nineten of those were being treated with atropine0.01% included 8 females, 11 Caucasians, 6 Asians and 2 Hispanics. The average amount of myopia at the start of treatment was 5.67 diopters with an average increase of 0.96 Diopters/year at first visit. The 11 controls had 5 females, 7 Caucasians, and 4 Asians. The average amount of myopia was 3.93 diopters with an increase of 1.5 diopters/year at first visit. The treatment group had an average increase in myopia of 0.48 diopters/year over 25 months of follow-up while the controls had an increase of 0.70 diopters/year over 19 months(p=0.16). When comparing the atropine group progression before and after treatment, the average increase/year was 0.96 versus 0.48 Diopter, respectively(p=0.0008). It is important to note, that two patients continued to have significant myopia progression on treatment with an increase of 1.74 diopters and 1.17 diopters per year. The atropine group reported blurred reading for two weeks. Two patients reported headaches and treatment was discontinued. The major negative outcome was a retinal detachment on treatment.
Discussion: This small retrospective case series does show statistically significant difference in the treatment group progression before and after treatment with atropine with minimal side-effects.
Conclusion: Before wide-spread use, it is imperative that a large randomized control trial be done to see if this treatment is efficacious.
References: 1. Rada JAS, Shelton S, Norton TT. The sclera and myopia. Exp Eye Res. 2006;82(2):185-200. doi:10.1016/j.exer.2005.08.009.
2. Saw S, Gazzard G, Shih-yen EC, Chua W. Myopia and associated pathological complications. 2005:381-391.