Additive effects of orthokeratology and atropine 0.01% ophthalmic solution in slowing axial elongation in children with myopia: first year results

• Published in: Japanese journal of ophthalmology Vol. 62; no. 5; pp. 544 - 553
• Main Authors: Kinoshita, Nozomi, Konno, Yasuhiro, Hamada, Naoki, Kanda, Yoshinobu, Shimmura-Tomita, Machiko, Kakehashi, Akihiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2018; Springer Nature B.V
• Subjects: Atropine; Atropine - administration & dosage; Axial Length, Eye - diagnostic imaging; Child; Children; Clinical Investigation; Cornea - diagnostic imaging; Corneal Topography; Disease Progression; Dose-Response Relationship, Drug; Elongation; Female; Follow-Up Studies; Humans; Interferometry; Laser interferometry; Male; Medicine; Medicine & Public Health; Mydriatics - administration & dosage; Myopia; Myopia - diagnosis; Myopia - physiopathology; Myopia - therapy; Ophthalmic Solutions; Ophthalmology; Orthokeratologic Procedures - methods; Prospective Studies; Refraction, Ocular - physiology; Time Factors; Treatment Outcome; Axial length; Orthokeratology; Atropine 0.01% ophthalmic solution; Additive effects; Myopia
• ISSN: 0021-5155; 1613-2246; 1613-2246
• DOI: 10.1007/s10384-018-0608-3

Purpose To investigate the additive effects of orthokeratology (OK) and atropine 0.01% ophthalmic solution, both of which are effective procedures to slow axial elongation in children with myopia. Study design Prospective randomized clinical trial. Methods Japanese children aged 8–12 years with a spherical equivalent refractive error of − 1.00 to − 6.00 diopters were included. A total of 41 participants who had been wearing the OK lenses successfully for 3 months were randomly allocated into two groups to receive either the combination of OK and atropine 0.01% ophthalmic solution (combination group) or monotherapy with OK (monotherapy group). Subjects in the combination group started to use atropine 0.01% ophthalmic solution once nightly from 3 months after the start of OK. Axial length was measured every 3 months using non-contact laser interferometry (IOLMaster), and the axial length measurement at month 3 of OK therapy was used as the baseline value in both groups. The increase in axial length over 1 year was compared between the two groups. Results A total of 40 consecutive subjects (20 subjects in the combination group and 20 in the monotherapy group) were followed for 1 year. The increase in axial length over 1 year was 0.09 ± 0.12 mm in the combination group and 0.19 ± 0.15 mm in the monotherapy group ( P  = 0.0356, unpaired t test). Conclusion During the 1-year follow-up, the combination of OK and atropine 0.01% ophthalmic solution was more effective in slowing axial elongation than OK monotherapy in children with myopia.