MYOPIA

In recent years, myopia (otherwise known as nearsightedness) has become a growing concern, affecting up to 50% of the adult population in the United States.1 In children, the prevalence of myopia is progressing, rising from 25% to 42% between 1971 and 1999.1 Some research has shown that “kids who are exposed to less outdoor daylight in early childhood are more likely to become myopic.”2 Those with a high degree of myopia are at an increased risk of developing more serious eye-related conditions like cataracts and glaucoma.3

While the cause of myopia is not exactly known, it occurs when the eye grows too long, thus changing the focus of images on the retina to just in front of the retina (Figure 1, 2), making it difficult to focus on objects farther away.3 Myopia is measured in diopters (D), which indicate the lens strength required for correction; high myopia is considered -5.0 to -6.0 diopters or greater.3

Figure 1 (Source: National Eye Institute)

Figure 2 (Source: National Eye Institute)

TREATMENTS

Some of the most common treatments for myopia consist of corrective glasses and contact lenses, or medical procedures like LASIK and laser surgeries. However, these options may be inconvenient, uncomfortable, or even come with unwanted side effects, especially for those who develop myopia at a young age.

Alternatively, recent studies on low-dose atropine as a treatment option have shown effectiveness in slowing the progression of myopia before severe correction is needed later in life. One study states that super-diluted atropine (0.01% concentration) reduced myopic progression by 25%.4 If myopia has already progressed to a certain point, kids treated with low-dose atropine may still need glasses; however, the rate of progression will significantly decrease.2

Studies of Atropine in the Treatment of Myopia (specifically the ATOM2 trial) have shown the effectiveness of low-dose atropine (0.01%) in Asian children; additional studies show that it can also work in other ethnic groups.5 While atropine is already being used medically to dilate the pupil or treat lazy eye, its use in slowing the progression of childhood myopia is becoming more mainstream in the US as ophthalmologists learn of low-dose atropine’s benefits and risks.

Benefits of low-dose atropine include a low occurrence of ocular and systemic side effects, particularly in children, who are the primary candidates for atropine therapy. It could also potentially circumvent the discomfort or unwanted side effects of corrective lenses and laser surgeries. Some risks of atropine in higher doses include: tachycardia, altered mental status, dry mouth, urinary retention, constipation, flushing of skin; however, none of these were reported among children using low-dose atropine (0.01%). There is also the potential for long-term development of an allergy to treatment.5

Eye growth is most rapid during childhood, so it is imperative to get “a diagnosis as early as possible and [use] atropine consistently through the eye’s growth years.”2

If you want to know more about low-dose atropine for slowing the progression of childhood myopia, get in touch with our pharmacists at pharmacist@innovationcompounding.com!

References:

  1. Pineles SL. Kraker RT. Et.al., Atropine for the Prevention of Myopia Progression in Children. American Academy of Ophthalmology. 2017; Vol. 124, Number 12.
  2. Kate Rauch. (2017, August 31). Low-Dose Atropine for Kids with Myopia. American Academy of Ophthamology. Retrieved June 27, 2018 from https://www.aao.org/eye-health/news/low-dose-atropine-kids-with-myopia
  3. Facts About Myopia. (2017, October). National Eye Institute. Retrieved June 27, 2018 from https://nei.nih.gov/health/errors/myopia
  4. Diaz-Llopis M., Pinazo-Duran MD. Superdiluted atropine at 0.01% reduces progression in children and adolescents. A 5-year study of safety and effectivemess. Arch Soc Esp Oftalmol. 2018; 93:182-185.

Nicola Parry, Contributing Writer, interviewing K. David Epley, MD, R. Michael Siatkowski, MD, and Donald Tan, MD, FRCS, FRCOphth. (2016, December). How to Use Low-Dose Atropine to Slow Myopic Progression in Kids. American Academy of Ophthamology. Retrieved June 21, 2018 from https://www.aao.org/eyenet/article/how-to-use-low-dose-atropine-to-slow-myopic-progre

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