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AIM: To investigate the effects of 0.01% atropine eye drops on macular blood flow density and retinal thickness in children with different degrees of myopia. METHODS: This was a prospective case-control study. Sixty-four patients (112 eyes) diagnosed with myopia for the first time with 0.01% atropine eye drops before and 6 months after medication were investigated with the uncorrected distance visual acuity (UCVA), axial length (AL), spherical equivalent (SE), macular ganglion cell-inner plexiform layer thicknes (mGCIPL) using slit lamp examination and optical coherence tomography (OCT), vascular density in the macular area and the area of the avascular in the fovea using optical coherence tomography angiography (OCTA) . Changes in various indicators before and after medication were compared. RESULTS: Compared with before medication, the AL of the three groups of myopia patients increased significantly (P0.05). The difference was statistically significant between the moderate myopia group and the high myopia group (P0.05). After 6 months of medication, the central circle macular vessel density (cCVD) increased in the low myopia group and moderate myopia group (P0.05). Before and after medication, there was no significant difference in outer circle macular vessel density (oCVD), inner circle macular vessel density (iCVD), and whole circle macular vessel density (wCVD) among the three myopia groups (P>0.05). The increase in mGCIPL was statistically significant in the low myopia group (P0.05). There was no significant difference in foveal avascular zone (FAZ) among the three myopia groups before and after medication (P>0.05). There was no correlation between CVD, AL, and SE in the three myopia groups (P>0.01). There was a low correlation between CVD and mGCIPL in the low myopia group (r=0.442, P0.01). CONCLUSION: 0.01% atropine can significantly reduce the rate of axial and refractive growth in children with low to moderate myopia, increase the density of central macular vessels, and increase the thickness of mGCIPL in children with low to moderate myopia.
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AIM: To report 5 cases with drug-induced bilateral acute ciliochoroidal effusion(DBACE)and myopic shift, with or without ocular hypertension(OHT), summarize patients' clinical characteristics and recovery process of DBACE, and investigate the possible pathophysiological mechanism.METHODS:A retrospective observational case study conducted from June 2017 to February 2021. The included patients were subjected to a series of ocular examinations listed as follows: 1)best corrected visual acuity; 2)intraocular pressure(IOP); 3)slit-lamp microscopy; 4)fundus photography; 5)ultrasound biomicroscopy(UBM); 6)subjective optometry; 7)axial length and anterior chamber depth. All patients were followed up every 2d until the diopters were completely restored to the state before the disease onset.RESULTS:In total, 5 patients aged 10-45 years old, including 3 female and 2 male patients, were enrolled in this study. All patients were bilaterally involved(5/5), and had myopic shift(5/5), of whom 3 patients had OHT(3/5). With the increase of age, myopic shift decreased, while OHT increased. Based on OHT, the dynamic aggravation process of DBACE was subdivided into 2 stages, stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). With the deterioration of DBACE, when myopic shift approached or exceeded the minimum amplitude of accommodation(MAA), IOP gradually rose, and DBACE progressed from stage 1 to stage 2. With the recovery of DBACE after discontinuing the suspicious drugs, DBACE in stage 2 first returned to stage 1, and then returned to normal.CONCLUSION:Pathophysiological mechanism of DBACE was subdivided into 2 stages, including stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). The transition between the two stages depends on the imbalance between myopic shift and MAA.
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Purpose: The present study was performed to compare the optical quality of the eyes of myopic children before and after treatment with atropine eye drops of different concentrations. Methods: In the study population of 71 patients (131 eyes), 34 patients (63 eyes) were given 0.01% atropine eye drops and 37 patients (68 eyes) were given 0.05% atropine eye drops. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs 100%, 20%, and 9%) under different lighting conditions were measured before and after two weeks of atropine treatment. Results: After using 0.05% atropine eye drops for two weeks, the Strehl ratio decreased from 0.27 ± 0.07 to 0.23 ± 0.07 (P = 0.0026), PVA 20% decreased from 1.15 ± 0.32 to 1.03 ± 0.36 (P = 0.0344), and PVA 9% decreased from 0.74 ± 0.23 to 0.64 ± 0.23 (P = 0.0073). The OSI was significantly higher after using 0.05% than 0.01% atropine eye drops (P = 0.0396), while both the Strehl ratio and PVA 20% were lower after using 0.05% than 0.01% atropine eye drops (P = 0.0087 and P = 0.0492, respectively). Conclusion: The children’s optical quality did not change significantly after using 0.01% atropine eye drops, whereas it decreased after using 0.05% atropine eye drops.
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Low?concentration atropine (LCA; 0.01%) is known to reduce the progression of myopia in axial myopes. The purpose of this study was to understand the role of LCA in premyopic children in preventing progression. Methods: A randomized case–control study of known premyopes was done between the use of LCA and no intervention. A total of 30 children were included in both groups. Results: The mean age in the LCA group was 7.7 ± 2.1 years (5–12 years), and in the control group, it was 7.2 ± 1.9 years (4–12 years). The mean baseline progression per year in the LCA group (before starting the eye drops) was ? 0.72 ± 0.3 D, and in the control group, it was ? 0.69 ± 0.4 D. At the end of the first year, the mean progression in the LCA group was ? 0.31 ± 0.3 D versus ? 0.76 ± 0.4 D, and the axial length increase was 0.12 ± 0.1 mm in the LCA group and 0.21 ± 0.2 mm in the control group. At the end of the second year, the mean progression compared with the baseline in the LCA group was ? 0.6 ± 0.3 D versus ? 1.75 ± 0.4 D, and the axial length showed an increase from baseline in the LCA group by 0.21 ± 0.2 mm, and in the control group, the increase was 0.48 ± 0.2 mm in 2 years. Conclusion: Low?concentration eye drops (0.01%) work in preventing the progression of axial myopia in premyopic children.
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@#As the prevalence of myopia continues to increase, our society shows increasing interest in the visual impairment associated with myopia and methods for myopia control. Current methods for myopia control include atropine, orthokeratology, dual-focus contact lenses, multifocal contact lenses, and functional frame glasses, <i>etc</i>. Low-concentration atropine(0.01%, 0.05%)became the first-line medication which has been administrated and shown to be effective in controlling the occurrence and progression of myopia. Meanwhile, low-concentration atropine shows longer-lasting effects, less frequent adverse effects and higher patients' acceptance than high-concentration atropine. This article reviews the efficacy, safety, time-to-treatment, and effects when combined with other treatments to provide evidence for the clinical application of low-concentration atropine on myopia control.
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@#AIM: To observe the control effects of low concentration atropines, orthokeratology, and spectacles on children with myopia in Baotou, and to analyze change rules of myopia-related regulatory parameters for providing bases for myopia preventions and controls.<p>METHODS: We selected 120 children with myopia aged 8-14 years old(240 eyes), treated in Ophthalmology Clinic of the First Affiliated Hospital of Baotou Medical College from June 2018 to December 2018. They were divided into three groups as follows: low concentration atropine group, orthokeratology group, and spectacles group. The accommodative lag, positive relative accommodation, negative relative accommodation, and diopter were followed up at 1, 3, 6, 12mo.<p>RESULTS:During the follow ups of 3, 6, and 12mo. We observed a statistically significant difference in the accommodative lag between the orthokeratology group and low concentration atropine group spectacles group(<i>P</i><0.05). At the 6, 12mo follow up, there was a statistical difference in the accommodative lag between the orthokeratology group and the spectacles group(<i>P</i><0.05). During the follow ups of 3, 6, and 12mo, there was a statistically significant difference in negative relative accommodations among the low concentration atropine group, orthokeratology group, and spectacles group(<i>P</i><0.05). The difference in positive relative accommodations was statistically significant among the orthokeratology group, low concentration atropine group, and spectacles group at each time point during the follow ups(<i>P</i><0.05). During the follow ups of 6, 12mo,the difference of equivalent spherical lens was statistically significant among the low concentration atropine group and spectacles group(<i>P</i><0.05). At the follow up 12mo, the difference between the equivalent spherical lens of the orthokeratology group and the spectacles group was statistically significant(<i>P</i><0.05).<p>CONCLUSION: The effects of three commonly used methods of controlling myopia on the accommodation parameters of myopic children are as follows: orthokeratology can not only solve the problem of hyperopia defocus by reducing accommodation lags but also improve positive relative accommodations, while it should be worn for a prolonged period. Low concentration atropine can improve the negative relative accommodations. However, there may be other ways to control myopia development. Compared to other groups, the spectacles group exerted fewer effects on each adjustment index, and did not demonstrate a significant effect on myopia control.
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@#AIM: To study the effects between low concentration atropine and orthokeratology on myopia prevention and control.<p>METHODS: Totally 150 cases of juvenile outpatients with myopia were chosen in our hospital. They were divided into 3 groups randomly. Group A(50 cases)were treated with low concentration atropine. Group B(50 cases)were treated with orthokeratology. Group C(50 cases)were treated with spectacles. Refractive degree and ocular axial length had no statistically significant differences between three groups before treatment. After 1a follow-up, refractive degree and ocular axial length of three groups were statistically analyzed. <p>RESULTS: After 1a, the refractive degree changes of each group before and after treatment were statistically significant(<i>P</i><0.01). The results of refractive degree changes among the groups were as follows: there was no significant differences between low concentration atropine group and orthokeratology group(<i>P</i>>0.05); compared with orthokeratology and low concentration atropine group, that of spectacles group was significantly different(<i>P</i>>0.05). After 1a follow up, the ocular axial length changes of each group before and after treatment were statistically significant(<i>P</i><0.01). The results of ocular axial length changes among the groups were as follows: there was no significant differences between low concentration atropine group and orthokeratology group(<i>P</i>>0.05); compared with orthokeratology and low concentration atropine group, that of spectacles group was significantly different(<i>P</i><0.05). <p>CONCLUSION: The effects of low concentration atropine and orthokeratology on controlling juvenile myopia and ocular axial length have no significant difference. They are superior to spectacles on controlling juvenile myopia.