Simonavičiūtė, Dovilė

Trumparegystė yra greičiausiai plintanti refrakcijos yda, kuri per pastaruosius dešimtmečius tapo reikšminga visuomenės sveikatos problema. Didėjantis trumparegystės paplitimas pabrėžia būtinybę gilinti žinias apie šios ligos rizikos veiksnius ir progresavimo kontrolės metodus. Atropino akių lašai yra plačiausiai pasaulyje vartojama farmakologinė priemonė trumparegystės progresavimui stabdyti. Tyrimo tikslas – nustatyti trumparegystės progresavimo sąsajas su akies funkciniais ir morfologiniais pokyčiais bei genetiniais žymenimis, gydant mažos koncentracijos atropino akių lašais. Darbo uždaviniai: 1. Įvertinti ir palyginti trumparegių vaikų akių klinikinę refrakciją ir morfologinius parametrus bei jų pokyčius 1 metų laikotarpiu, gydant mažos koncentracijos (0,01 proc. arba 0,03 proc.) atropino akių lašais. 2. Nustatyti trumparegių vaikų regos sutrikimų ir skundų dėl akių diskomforto sąsajas su ilgalaikiu mažos koncentracijos (0,01 proc. arba 0,03 proc.) atropino akių lašų vartojimu 1 metų laikotarpiu. 3. Nustatyti akių ligomis nesergantiems ir trumparegiams vaikams vieno nukleotido variantus COL1A1 (rs2075555, rs2269336, rs1107946) ir APLP2 (rs7127037) bei įvertinti jų sąsajas su trumparegystės atsiradimu ir progresavimu. 4. Nustatyti trumparegių vaikų akių klinikinės refrakcijos ir morfologinių akių parametrų bei jų pokyčių sąsajas su gyvensenos veiksniais, gydant mažos koncentracijos (0,01 proc. arba 0,03 proc.) atropino akių lašais.

Purpose: To evaluate the impact of 0.01% and 0.03% atropine eye drops on myopia progression. Methods: Healthy children aged 6-12 years with cycloplegic spherical equivalent (SE) between -0.75D and -5.0D and astigmatism ≤1.5D were included. They were assigned to the control or atropine groups, with the option to use 0.01% or 0.03% atropine eye drops once in the evening for 1-year. Cycloplegic SE and ocular axial length (AL) were measured at the baseline and after 1-year follow-up. Myopia progression was evaluated by changes in SE and AL over 1-year, analysing measurement of the right eye only. Results: 69 children were in the control group, 62 children in the 0.01% and 33 in the 0.03% atropine groups. No statistically significant differences were observed in age (p=0.893) or gender distribution (p=0.332) between groups. Baseline SE and AL parameters were not statistically different between the groups as well (p>0.05). In terms of change in SE over 1-year, a significant difference was observed between the 0.03% and 0.01% atropine groups (p=0.008) as well as between the 0.03% atropine eye drops and control groups (p=0.040). Median SE changes were as follows: -0.25 (-1.0 – 0.63)D, -0.50 (-1.50 – 0.50)D and -0.50 (-2.25 – 0.50)D in the 0.03%, 0.01% atropine eye drops and control groups, respectively. Statistically significant difference in AL change was also found between 0.03% and 0.01% atropine eye drops groups (p=0.021) and between the 0.03% atropine and control groups (p=0.008). Mean AL changes were: 0.18 (0.14) mm, 0.30 (0.18) mm and 0.31 (0.21) mm in the 0.03%, 0.01% atropine eye drops and control groups, respectively. Conclusion: The 0.03% atropine eye drops effectively controlled myopia progression during 1-year, showing superiority compared to 0.01% atropine eye drops in reducing changes in SE and AL.

Aims/Purpose: Atropine eye drops of various concentrations are widely used to slow the progression of myopia, yet the precise mechanism through which atropine achieves this control remains unclear (1). Studies have shown that choroidal thickness (ChT) decreases as myopia progresses (2) and atropine eye drops have been shown to increase choroidal thickness (3). Methods: Healthy children aged 6‐12 years with cycloplegic spherical equivalent (SE) from ‐0.5 D to ‐5.0 D and astigmatism ≤1.5D were included. Participants were assigned to the control group or 0.01% atropine eye drops group. The atropine group received 0.01% atropine eye drops once in the evening for 1 year. ChT was assessed in 9 areas using the Early Treatment Diabetic Retinopathy Study (ETDRS) automated grid layout with swept‐source optical coherence tomography (SS‐OCT) at the baseline and after 1‐year follow‐up. Only measurements of the right eye were analyzed. Results: 31 children were in the control group and 35 in the 0.01% atropine group. The median age was 10 (6‐12) years in the control group and 10 (7‐12) years in the 0.01% atropine group (p = 0.880). There were 22 girls in the control group and 20 in the 0.01% atropine group (p = 0.244). Baseline ChT in all 9 areas were similar between the groups (p > 0.05). After 1‐year follow‐up, changes in choroidal thickness remained similar in all 9 areas between the control and 0.01% atropine groups (p > 0.05). Conclusions: The administration of 0.01% atropine eye drops did not result in a significant change in ChT over 1‐year follow‐up period compared to the control group in myopic children. Future research should focus on longer follow‐up periods and explore different concentrations of atropine to fully understand its effects on ChT. References Upadhyay A, Beuerman RW. Biological Mechanisms of Atropine Control of Myopia. Eye Contact Lens. 2020 May;46(3):129‐135. doi: 10.1097/ICL.0000000000000677. PMID: 31899695; PMCID: PMC7176345. Gupta P, Saw SM, Cheung CY, et al. Choroidal thickness and high myopia: a case‐control study of young Chinese men in Singapore. Acta Ophthalmol. 2015;93(7):e585‐e592. doi:10.1111/aos.12631 Li W, Jiang R, Zhu Y, Zhou J, Cui C. Effect of 0.01% atropine eye drops on choroidal thickness in myopic children. J Fr Ophtalmol. 2020;43(9):862‐868. doi:10.1016/j.jfo.2020.04.023

Background and Objectives: Myopia is the most widespread ocular disorder globally and its prevalence has been increasing over the past decades. Atropine eye drops stand out as the only pharmacological intervention used in clinical practice to control myopia progression. The aim of this study was to explore the effect of 0.01% atropine eye drops on myopia progression. Patients and Methods: Healthy children aged 6–12 years with cycloplegic spherical equivalent (SE) from −0.5 D to −5.0 D and astigmatism ≤1.5 D were included. Myopia progression was assessed by changes in SE and axial length (AL) over 1 year and SE changes 1 year before the study enrollment and during the 1-year follow-up. Adverse events were evaluated based on complaints reported by either parents or the children themselves during follow-up visits. Results: The analysis involved 55 patients in the 0.01% atropine eye drops group and 66 in the control group. After the 1-year follow-up, the change in SE was −0.50 (−2.25–0.50) D in the control group compared to −0.50 (−1.50–0.50) D in the 0.01% atropine group (p = 0.935); AL change was 0.31 (0.18) mm in the control group and 0.29 (0.18) mm in the 0.01% atropine group (p = 0.480). The change in SE was −0.68 (−2.0–−0.25) D/year before the study and remained similar −0.50 (−2.25–0.25) D over the 1-year follow-up in the control group (p = 0.111); SE change was reduced from −1.01 (−2.0–−0.25) D/year before the study to −0.50 (−1.5–0.5) D over the 1-year follow-up in the 0.01% atropine group (p < 0.001). In the 0.01% atropine group, ten (16.4%) children experienced mild adverse events, including blurred near vision, ocular discomfort, photophobia, dry eyes, and anisocoria. Conclusions: Compared to the control group, the administration of 0.01% atropine eye drops demonstrated no significant effect on changes in SE and AL over a 1-year follow-up. However, children in the 0.01% atropine group initially experienced higher myopia progression, which decreased with treatment over the course of 1 year. Future studies should explore the long-term effects, rebound effects, potential genetic associations, and efficacy of higher doses of atropine in managing myopia progression.

To investigate the efficacy and safety of one-year treatment with 0.03% atropine eye drops for slowing myopia progression among children aged 6-12 years. Healthy Caucasian children aged 6-12 years with cycloplegic spherical equivalent (SE) from -1.0 D to -5.0 D and astigmatism and anisometropia ≤1.5 D were included. Changes in mean axial length (AL) and objective SE as well as changes in intraocular pressure (IOP), central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT) were assessed in the 0.03% atropine eye drops group and the control group from baseline through the 1-year follow-up. The proportion of participants showing myopia progression of <0.5 D from baseline in each group and any potential side effects in 0.03% atropine group were evaluated. The study involved 31 patients in the 0.03% atropine eye drops group and 41 in the control group. Administration of 0.03% atropine for 1 year resulted in a mean change in SE of -0.34 (0.44) D/year, significantly lower than the -0.60 (0.50) D/year observed in the control group ( = 0.024). The change in AL was 0.19 (0.17) mm in the 0.03% atropine group, compared to 0.31 (0.20) mm in the control group ( = 0.015). There were no significant differences in changes of IOP, CCT and LT between the groups (all ≥ 0.05). The 0.03% atropine group had a significantly greater increase in ACD compared to the control group ( = 0.015). In total, 64.5% of patients in the 0.03% atropine group showed progression <0.5 D/year, in contrast to 39.0% in the control group ( = 0.032). Adverse events were reported in 13 (35.0%) out of 37 patients in the treatment group, leading to discontinuation of the eye drops in six (16.0%) cases. None of the adverse events were severe. Despite a higher incidence of adverse events, 0.03% atropine eye drops effectively slowed the progression of myopia over 1-year.

Introduction Myopia stands as the most prevalent ocular disorder on global scale (1). Various parameters, such as choroidal thickness (CT), refractive error, and axial length (AL), offer insights into development of myopia (2). Aim To investigate the relationship between the degree of myopia, AL and CT.

Introduction Myopia is a widespread global ocular disorder (1). Atropine eye drops are sole pharmacological intervention used in clinical practice for myopia control (2).Atropine is a nonselective muscarinic receptor antagonist and the exact target of action and the mechanism by which atropine eye drops slow the progression of myopia remain unclear (3). Aim To assess tolerability and effect of 0.01% atropine eye drops on ocular biometric parameters.

Įvadas. Endokrininė oftalmopatija yra sudėtinė autoimuninė liga, galinti sukelti akių diskomfortą, regos praradimą ir gyvenimo kokybės pablogėjimą. [...].

Purpose: To evaluate changes of ocular parameters in myopic children receiving 0.01% atropine eye drops over a one-year period. Methods: Cycloplegic spherical equivalent (SE) refraction and tonometry were evaluated using TonoRef (III). Ocular axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT) were measured using IOL Master. Healthy children from 6 to 12 years old, whose cycloplegic SE refraction was from -0.5 to -5.5, astigmatism 1.50 D or less and known one-year myopia progression were included to the study and randomly assigned to the treatment or control groups. Only measurements of the right eye were included. The results are presented as average (±SD). Results: 43 children were allocated to the control group and 42 children to the 0.01% atropine eye drops group. There was no statistically significant difference between the groups regarding the age (p=0.423) and gender (p=0.826). Baseline AL and SE were statistically difference between the groups with longer AL and lower SE in atropine group: AL 24.04 (±0.94) mm and 24.61 (±0.68) mm (p=0.002), SE -2.10 (±0.87) D and -2.80 (±1.28) D (p=0.004). Prior to the study, SE progression was -0.74 (±0.46) D/year in the control group and -1.00 (0.48) D/year in atropine group (p=0.004); over 1-year follow-up, SE progression rate in the control group was -0.59 (±0.50) (p=0.150) and decreased to -0.54 (±0.41) D in the atropine group (p<0.001). Changes in ACD, LT, CCT and IOP remained similar in the groups: ACD 0.01 (±0.05) mm and 0.02 (±0.06) mm, LT -0.01 (±0.05) mm and -0.02 (±0.05) mm, CCT -0.24 (±6.39) µm and -0.50 (±6.30) µm, IOP -0.32 (±2.48) mmHg and 0.44 (±2.94) mmHg in the control group and atropine group, respectively (p>0.05). Conclusions: Usage of 0.01% atropine eye drops reduced myopia progression based on changes in SE and had no effect on IOP, ACD, LT, CCT over the period of 12 months.

Atropino lašai yra viena veiksmingiausių trumparegystės progresavimą lėtinančių priemonių. Straipsnyje apžvelgiama daugiau nei 50 m. atropino veikimo mechanizmo nagrinėjimo istorija ir pateikiamos galimos veikimo lokalizacijos bei mechanizmai. Mokslinė literatūros paieška atlikta MEDLINE duomenų bazėje, naudojant raktažodžius anglų kalba. Atrinkta 14 visateksčių straipsnių anglų kalba, kurių pagrindinė tema atitiko apžvalgos tikslą. Konteksto sukūrimui naudoti pagalbiniai straipsniai, pagrindinę temą atitinkantys iš dalies. Apžvalga atskleidžia, jog atropino veikimo mechanizmas lėtinant trumparegystės progresavimą išlieka neaiškus, tačiau tema aktuali tolesnėms studijoms.