Zhi Chen1, Shengmei Huang2, Jiaqi Zhou1, Qu Xiaomei1, Xingtao Zhou1, Feng Xue3. 1. Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. 2. Department of Ophthalmology, Shanghai Gongli Hospital of Pudong New Area, Shanghai, China. 3. Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Shanghai, China; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: Lilyxue80@vip.163.com.
Abstract
PURPOSE: To investigate the adjunctive effect of orthokeratology (ortho-k) and low-dose atropine eye drops on axial length elongation in fast-progressing myopic children. METHODS: Axial elongation in 60 eyes of 60 subjects who completed two years of ortho-k treatment was retrospectively reviewed. They were aged between 5.6-11.6 (mean, 8.3 ± 1.5) years old when they started ortho-k treatment. During their first year of ortho-k treatment (Phase One), they all demonstrated a faster than 0.25 mm/yr axial elongation rate. They were then treated with nightly 0.01% atropine in addition to ortho-k treatment for another year (Phase Two). Annual axial elongation rates before and after atropine treatment were compared. RESULTS: Baseline spherical equivalent refractive error was -2.65 ± 1.08 DS and axial length was 24.34 ± 0.92 mm for the study cohort. The mean axial elongation rate was 0.46 ± 0.16 mm/yr during Phase One, being significantly faster in younger children (t = -4.920, P < 0.001). When atropine was added, annual axial elongation rate significantly decreased to 0.14 ± 0.14 mm/yr (t = -11.988, P < 0.001), and those who were fast progressors in Phase One had a greater reduction in the rate of axial elongation during Phase Two (t = -8.052, P < 0.001). CONCLUSIONS: Axial elongation rate is faster in younger children undergoing ortho-k treatment. For fast myopia progressors, low dose atropine may significantly slow axial elongation in addition to ortho-k's treatment effect. Those who have faster axial elongation after ortho-k treatment will benefit more from the addition of low dose atropine, regardless of their refractive error and age.
PURPOSE: To investigate the adjunctive effect of orthokeratology (ortho-k) and low-dose atropine eye drops on axial length elongation in fast-progressing myopic children. METHODS: Axial elongation in 60 eyes of 60 subjects who completed two years of ortho-k treatment was retrospectively reviewed. They were aged between 5.6-11.6 (mean, 8.3 ± 1.5) years old when they started ortho-k treatment. During their first year of ortho-k treatment (Phase One), they all demonstrated a faster than 0.25 mm/yr axial elongation rate. They were then treated with nightly 0.01% atropine in addition to ortho-k treatment for another year (Phase Two). Annual axial elongation rates before and after atropine treatment were compared. RESULTS: Baseline spherical equivalent refractive error was -2.65 ± 1.08 DS and axial length was 24.34 ± 0.92 mm for the study cohort. The mean axial elongation rate was 0.46 ± 0.16 mm/yr during Phase One, being significantly faster in younger children (t = -4.920, P < 0.001). When atropine was added, annual axial elongation rate significantly decreased to 0.14 ± 0.14 mm/yr (t = -11.988, P < 0.001), and those who were fast progressors in Phase One had a greater reduction in the rate of axial elongation during Phase Two (t = -8.052, P < 0.001). CONCLUSIONS: Axial elongation rate is faster in younger children undergoing ortho-k treatment. For fast myopia progressors, low dose atropine may significantly slow axial elongation in addition to ortho-k's treatment effect. Those who have faster axial elongation after ortho-k treatment will benefit more from the addition of low dose atropine, regardless of their refractive error and age.
Authors: Monica Jong; Jost B Jonas; James S Wolffsohn; David A Berntsen; Pauline Cho; Danielle Clarkson-Townsend; Daniel I Flitcroft; Kate L Gifford; Annechien E G Haarman; Machelle T Pardue; Kathryn Richdale; Padmaja Sankaridurg; Milly S Tedja; Christine F Wildsoet; Joan E Bailey-Wilson; Jeremy A Guggenheim; Christopher J Hammond; Jaakko Kaprio; Stuart MacGregor; David A Mackey; Anthony M Musolf; Caroline C W Klaver; Virginie J M Verhoeven; Veronique Vitart; Earl L Smith Journal: Invest Ophthalmol Vis Sci Date: 2021-04-28 Impact factor: 4.799