A meta analysis on atropine controlling myopia progression in children / 中华实验眼科杂志

Objective To examine the published evidence on the effectiveness of topical atropine for the prevention childhood myopia progression and the myopic rebound occurring after cessation of atropine.Methods A meta analysis,with a focus on randomized controlled trials (RCTs),was conducted by using the following electronic databases:PubMed,EMBASE,and Cohrane Library.The search strategy were ‘ myopia’ OR ‘ refractive error’ OR ‘ nearsighted’ AND ‘ atropine’ OR ‘ anti-muscarinic’ AND ‘ child’ OR ‘ children’ OR ‘ kids’ OR ‘ adolescent’.The last search was run on April 9,2019 and Jadad scoring system was used to evaluate the quality of each RCT.Results Eleven RCTs with 3 162 children aged 5-15 years and spherical equivalent ranging-0.50 to-6.75 D were included.Most of the studies found a beneficial effect in myopic control when treated with atropine compared with various control groups.The mean difference (MD) between the treatment and control groups in myopic progression were 0.95 D/year (95％ confidence interval [CI]:0.69-1.22),0.93 D/year (95％ CI:0.50-1.36),0.82 D/year (95％ CI:0.68-0.96),0.46 D/year (95％ CI:-0.02-0.94) for 1.0％,0.5％,0.1％ and 0.01％ topical atropine,respectively (P＜0.001).After 12 months of atropine cessation,the analysis indicated that the MD between the different dosage of atropine,used during the treatment period,and the control group was-0.36 D/year (95％ CI:-0.70--0.02,P=0.04,I2:98％).Conclusions Atropine is a potent option in myopic control.Even though,a myopic rebound was reported after treatment cessation,atropine-treated eyes have a slower myopia progression compare to controls.Low dosages of atropine (especially 0.01％) seem to have minimal rebound effect and few side effects.

Multiple Eccrine Hidrocystoma Treatedwith 1% Topical Atropine Sulfate

We report a case of multiple eccrine hidrocystoma (MEH) in a 57-year-old woman who had asymptomatic, discrete, skin-colored, shiny, firm papulovesicles on the face. These lesions enlarged during summer or when the patient did housework, and decreased in sue during winter or rest. Histologic examination showed a dilated, unilocular, cystic, invaginated structure within the middle dermis. The wall of the cyst generally consisted of two layers of Rat or cuboida1 epithelial cells. Decapitation secretion and myoepithelial cells were not observed. The lesions improved markedly with 1% topical atropine sulfate.