J 2024

Evaluation of Accommodation and Pupillary Reaction in Children with Myopia Treated by Highly Diluted Atropine in the M.A.R.S Trial

DOSTÁLEK, Miroslav; Martin HLOŽÁNEK; Barbora ČÁSLAVSKÁ; Lucie JEŘÁBKOVÁ; Radka ŠTĚPÁNOVÁ et al.

Základní údaje

Originální název

Evaluation of Accommodation and Pupillary Reaction in Children with Myopia Treated by Highly Diluted Atropine in the M.A.R.S Trial

Autoři

DOSTÁLEK, Miroslav; Martin HLOŽÁNEK; Barbora ČÁSLAVSKÁ; Lucie JEŘÁBKOVÁ; Radka ŠTĚPÁNOVÁ; Rudolf AUTRATA; Jarmila HEISSIGEROVÁ; Inka KREJČÍŘOVÁ; Martin KOMÍNEK; Barbora ŽAJDLÍKOVÁ a Jorge L. ALIO

Vydání

Journal of Clinical Case Studies Reviews & Reports, United Kingdom, Scientific Research and Community Ltd, 2024, 2634-680X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30207 Ophthalmology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00137853

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Myopia in Children; Progressive Myopia; Low-Dose Atropine; Diluted Atropine Atropine Eye Drops; Axial Length of Eye; Accommodation; Pupilar Diameter

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 17. 1. 2025 08:46, Mgr. Tereza Miškechová

Anotace

V originále

Background: Myopia is a growing challenge in paediatric ophthalmology. Despite the benefits of novel therapeutic approaches, it is essential to assess their side effects. The aim of this study was to determine the impact of twelve months of local application of 0.02% and 0.04% atropine and placebo on the static and dynamic features of accommodation and pupil diameter, representing prominent side effects of myopia progression treatment. Methods: This study involved 127 subjects aged 6-11 years who were randomized to the M.A.R.S. trial, a randomized, double-masked, placebo-controlled multicentre study investigating the efficacy, safety, and side effects of highly diluted atropine collyrium (0.02% and 0.04%) in slowing the progression of myopia. Photopic and mesopic light-adapted horizontal pupillary diameters (PD; mm) were measured. Static accommodation capability was assessed monocularly and binocularly as the amplitude of accommodation (AoA; dioptres) calculated as the inverted value of the measured near point of accommodation in meters. The dynamic properties of accommodation were represented by the near accommodation facility (NAF, ±1.25 D flipper; monocularly/binocularly; number of cycles in a 60-second interval). Results: The effects of atropine on static PD were treatment-related (P<0.001) and dose-unrelated. Under photopic and mesopic light conditions, changes from baseline after twelve months of treatment were observed: in the 0.02% atropine group: from 3.48 ±1.23 to 4.65 ±1.52 (P<0.001); from 5.59 ±1.34 to 6.33 ±1.14 (P<0.001), respectively; in the 0.04% group: from 3.41±1.27 to 4.86±1.64 (P<0.001); and from 5.64±1.13 to 6.55±0.82 (P<0.001), respectively. The effects of the study medication on AoA were not treatment-related in the break point and were marginally treatment-related in the recovery point (P=0.049) in monocular tests. The results of the binocular tests were treatment-unrelated in the break point or at the recovery point. There were no statistically significant differences in NAF among the groups after the 12-month treatment period in monocular and binocular conditions. Conclusions: Local 0.02% and 0.04% atropine treatment for twelve months resulted in treatment-related increases in photopic and mesopic PD, respectively. Accommodation capability, assessed by AoA, was diminished by atropine treatment only at extreme limits (due to enlarged NPA distances) but remained unchanged at standard near working distances (as indicated by unaltered NAF test results) according to the M.A.R.S. trial data.

Návaznosti

90249, velká výzkumná infrastruktura
Název: CZECRIN IV