Journal
CONTACT LENS & ANTERIOR EYE
Volume 46, Issue 1, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.clae.2022.101723
Keywords
Atropine; Orthokeratology; Combined treatment; Myopia control
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This study found that combining 0.01% atropine with orthokeratology (AOK) has a better effect in retarding axial elongation compared to orthokeratology alone (OK). The study included 96 Chinese children aged 6 to 11 years with myopia and showed that the AOK group had significantly slower axial elongation compared to the OK group. The AOK group also exhibited larger pupil dilation and choroidal thickening.
Background: To investigate whether combining 0.01% atropine with orthokeratology (AOK) has a better effect in retarding axial elongation, compared with orthokeratology alone (OK) over two years. Methods: A total of 96 Chinese children aged six to < 11 years with myopia (1.00 - 4.00 D, inclusive) were randomized into either the AOK or OK group in a 1:1 ratio. Axial length (the primary outcome), and secondary outcomes (e.g. pupil size and choroidal thickness) were measured at 1-month and at 6-monthly intervals after commencement of treatment. Results: Both intention-to-treat and per-protocol analyses showed significantly slower axial elongation in the AOK group than OK group over two years (P = 0.008, P < 0.001, respectively). AOK subjects had statistically slower axial elongation (adjusted mean [standard error], 0.17 [0.03] mm vs 0.34 [0.03] mm, P < 0.001), larger increase in mesopic (0.70 [0.09] mm vs 0.31 [0.09] mm, P 1/4 0.003) and photopic pupil size (0.78 [0.07] mm vs 0.23 [0.07] mm, P < 0.001), and greater thickening of the choroid (22.6 [3.5] mu m vs-9.0 [3.5] mu m, P < 0.001) than OK subjects over two years. Except for a higher incidence of photophobia in the AOK group (P = 0.006), there were no differences in the incidence of any other symptom or adverse events between the two groups. Slower axial elongation was associated with a larger increase in the photopic pupil size and a greater thickening in the choroid in the AOK group. Conclusions: Slower axial elongation following 2-year AOK treatment may result from increased pupil dilation and a thickening in the choroid observed in the AOK group.
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