To evaluate the effect of low concentration atropine combined with Orthokeratology (OK) lens compared with the OK lens on the changes of axial length in children with moderate and low myopia by meta-analysis.
Methods:
Databases such as PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched to collect related studies on atropine combined with the OK lens in the treatment of children with moderate and low myopia. The retrieval time was from the establishment of the database to December 2020. The standardized mean difference (SMD) and its 95% confidence interval (CI) were selected as the effect to analyze the changes of the axial length of the eye axis in children with low and moderate myopia treated with low concentration atropine combined with OK lens.
Results:
A total of eight articles were included in this study. Compared with OK lens treatment, low concentration atropine combined with the OK lens significantly slowed down the axial elongation of low and moderate myopia, SMD = −0.68(95% CI: −0.86–−0.50, p < 0.05). According to the subgroup analysis of treatment time, when the treatment time was less than or equal to 6 months, SMD = −0.63(95% CI: −0.88–−0.37, p < 0.05), when the treatment time was 1 year, SMD = −0.76(95% CI: −1.08–−0.43, p < 0.05), and when the treatment time was 2 years, SMD = −0.69(95% CI: −1.07–−0.31, p < 0.05).
Conclusion:
Low concentration atropine combined with the OK lens is more effective than the OK lens in the treatment of children with low to moderate myopia in reducing axial elongation.
HoldenBAFrickeTRWilsonDA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology2016; 123(5): 1036.
2.
MorganIRoseK.How genetic is school myopia?Prog Retin Eye Res2005; 24(1): 1–38.
3.
SawSMTongLChuaWH, et al. Incidence and progression of myopia in Singaporean school children. Invest Ophth Vis Sci2005; 46(1): 51–57.
4.
ChengCYWangNWongTY, et al. Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections. Br J Ophthalmol2020; 104(5): 616–622.
5.
VishweswaraiahSSwierkowskaJRatnamalaU, et al. Epigenetically dysregulated genes and pathways implicated in the pathogenesis of non-syndromic high myopia. Sci Rep2019; 9(1): 4145.
6.
OnoKHiratsukaYMurakamiA.Global inequality in eye health: country-level analysis from the Global Burden of Disease Study. Am J Public Health2010; 100(9): 1784–1788.
7.
CruickshankFELoganNS.Optical ‘dampening’ of the refractive error to axial length ratio: implications for outcome measures in myopia control studies. Ophthalmic Physiol Opt2018; 38(3): 290–297.
8.
KinoshitaNKonnoYHamadaN, et al. Additive effects of orthokeratology and atropine 0.01% ophthalmic solution in slowing axial elongation in children with myopia: first year results. Jpn J Ophthalmol2018; 62(5): 544–553.
9.
LeeYCWangJHChiuCJ.Effect of orthokeratology on myopia progression: twelve-year results of a retrospective cohort study. Bmc Ophthalmol2017; 17(1): 243.
10.
WallineJJLindsleyKBVedulaSS, et al. Interventions to slow progression of myopia in children. Cochrane Database Syst Rev2020; 1(1): D4916.
11.
GuanMZhaoWGengY, et al. Changes in axial length after orthokeratology lens treatment for myopia: a meta-analysis. Int Ophthalmol2020; 40(1): 255–265.
12.
LiSMKangMTWuSS, et al. Efficacy, safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis. Curr Eye Res2016; 41(5): 600–608.
13.
BedrossianRH.The effect of atropine on myopia. Ophthalmology1979; 86(5): 713–717.
14.
ZhuQTangYGuoL, et al. Efficacy and safety of 1% atropine on retardation of moderate myopia progression in Chinese school children. Int J Med Sci2020; 17(2): 176–181.
15.
TranHDMTranYHTranTD, et al. A Review of myopia control with atropine. J Ocul Pharmacol Ther2018; 34(5): 374–379.
16.
YamJCJiangYTangSM, et al. Low-concentration atropine for myopia progression (LAMP) study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology2019; 126(1): 113–124.
17.
SacchiMSerafinoMVillaniE, et al. Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients. Acta Ophthalmol2019; 97(8): e1136–e1140.
18.
ZhaoWLiZHuY, et al. Short-term effects of atropine combined with orthokeratology (ACO) on choroidal thickness. Contact Lens Anterio Eye. Epub ahead of print 30 June 2020. DOI: 10.1016/j.clae.2020.06.006.
19.
HigginsJPGreenS. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration. . Available at: http://handbook-5-1.cochrane.org/. (2011).
20.
StangA.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol2010; 25(9): 603–605.
21.
TanQNgALChengGP, et al. Combined atropine with orthokeratology for myopia control: study design and preliminary results. Curr Eye Res2019; 44(6): 671–678.
22.
VincentSJTanQNgALK, et al. Higher order aberrations and axial elongation in combined 0.01% atropine with orthokeratology for myopia control. Ophthal Physl Opt2020; 40(6): 728–737.
23.
KinoshitaNKonnoYHamadaN, et al. Efficacy of combined orthokeratology and 0.01% atropine solution for slowing axial elongation in children with myopia: a 2-year randomised trial. Sci Rep2020; 10(1): 1.
24.
TanQNgALChoyBN, et al. One-year results of 0.01% atropine with orthokeratology (AOK) study: a randomised clinical trial. Ophthal Physl Opt2020; 40(5): 557–566.
25.
ChenZHuangSZhouJ, et al. Adjunctive effect of orthokeratology and low dose atropine on axial elongation in fast-progressing myopic children—a preliminary retrospective study. Contact Lens Anterio Eye. Epub ahead of print 24 November 2018. DOI: 10.1016/j.clae.2018.10.026.
26.
WanLChenCS, et al. The Synergistic Effects of Orthokeratology and Atropine in Slowing the Progression of Myopia. J Clin Med.2018;7(9):259.
27.
ShihYFChenCHChouAC, et al. Effects of different concentrations of atropine on controlling myopia in myopic children. J Ocul Pharmacol Ther1999; 15(1): 85.
28.
GongQJanowskiMLuoM, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis. Jama Ophthalmol2017; 135(6): 624–630.
29.
GuoLFanLTaoJ, et al. Use of topical 0.01% atropine for controlling near work-induced transient myopia: a randomized, double-masked, placebo-controlled study. J Ocul Pharmacol Ther2020; 36(2): 97–101.
30.
LarkinGLTahirAEpleyKD, et al. Atropine 0.01% eye drops for myopia control in american children: a multiethnic sample across three US sites. Ophthalmol Ther2019; 8(4): 589–598.
31.
ChengJYangYKongX, et al. The effect of 0.01% atropine eye drops on the ocular surface in children for the control of myopia-the primary results from a six-month prospective study. Ther Clin Risk Manag2020; 16: 735–740.
32.
KamKWYungWLiGKH, et al. Infectious keratitis and orthokeratology lens use: a systematic review. Infection2017; 45(6): 727–735.
33.
LiJDongPLiuH.Effect of overnight wear orthokeratology lenses on corneal shape and tears. Eye Contact Lens2018; 44(5): 304–307.
34.
ChooJDHoldenBAPapasEB, et al. Adhesion of Pseudomonas aeruginosa to orthokeratology and alignment lenses. Optom Vis Sci2009; 86(2): 93–97.
35.
WangSWangJWangN.Combined orthokeratology with atropine for children with myopia: a meta-analysis. Ophthalmic Res. Epub ahead of print 11 August 2020. DOI: 10.1159/000510779.
36.
GaoCWanSZhangY, et al. The efficacy of atropine combined with orthokeratology in slowing axial elongation of myopia children: a meta-analysis. Eye Contact Lens. Epub ahead of print 13 October 2020. DOI: 10.1097/ICL.0000000000000746.
