Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents

NIE Yingying; YANG Yanrong; WANG Yin; TANG Wen; DUAN Junguo

doi:10.16835/j.cnki.1000-9817.2021.09.038

Volume 42 Issue 9

Sep. 2021

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Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2021 > 42(9): 1431-1435, 1440

NIE Yingying, YANG Yanrong, WANG Yin, TANG Wen, DUAN Junguo. Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1431-1435, 1440. doi: 10.16835/j.cnki.1000-9817.2021.09.038

Citation:

NIE Yingying, YANG Yanrong, WANG Yin, TANG Wen, DUAN Junguo. Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1431-1435, 1440. doi: 10.16835/j.cnki.1000-9817.2021.09.038

Citation:

NIE Yingying, YANG Yanrong, WANG Yin, TANG Wen, DUAN Junguo. Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(9): 1431-1435, 1440. doi: 10.16835/j.cnki.1000-9817.2021.09.038

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Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents

doi: 10.16835/j.cnki.1000-9817.2021.09.038

1.
Eye School of Chengdu University of Traditional Chinese Medicine, Chengdu(610000), China

Received Date: 2021-02-01
Rev Recd Date: 2021-03-25

Available Online: 2021-09-24

Publish Date: 2021-09-24

Abstract

Abstract

Myopia is a common refractive error in the process of development. With the high incidence and low age of myopia in children and adolescents, it has become a worldwide public health problem, seriously endangering physical and mental health. The prevention and control of myopia has a long way to go. Low concentration atropine, as an M-type choline receptor inhibitor, has been proved by medical research to effectively delay the progress of myopia. This paper reviews the relevant studies at home and abroad in recent years. The optimal concentration of low concentration atropine, the best clinical regimen and possible potential side effects were discussed. From the point of view of school public health, this paper discusses the significance of low concentration atropine for the prevention and control of myopia among school-age students, in order to provide a reliable basis and new ideas for the follow-up clinical application of atropine and myopia prevention and control strategies for school students.
- Atropine,
- Myopia,
- Child,
- Adolescent

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References(63)

References

[1]	国家卫生健康委. 2018年全国儿童青少年总体近视率为53.6%[J]. 现代养生(下半月版), 2019(10): 1-2. https://www.cnki.com.cn/Article/CJFDTOTAL-YSXD201910003.htm Health Committee. The overall myopia rate of children and adolescents in China in 2018 was 53.6%[J]. Mod Health Preserv(Second Half Edit), 2019(10): 1-2. https://www.cnki.com.cn/Article/CJFDTOTAL-YSXD201910003.htm
[2]	SAM S M, NIETO F J, KATZ J, et al. Factors related to the progression of myopia in Singaporean children[J]. Optom Vis Sci, 2000, 77(10): 549-554. doi: 10.1097/00006324-200010000-00009
[3]	樊泽民, 刘立京. 全面加强儿童青少年近视防控和视力健康管理[J]. 中国学校卫生, 2018, 39(8): 1121-1123, 1131. doi: 10.16835/j.cnki.1000-9817.2018.08.001 FAN Z M, LIU L J. Comprehensively strengthen the prevention and control of myopia and vision health management among children and adolescents[J]. Chin J Sch Health, 2018, 39(8): 1121-1123, 1131. doi: 10.16835/j.cnki.1000-9817.2018.08.001
[4]	HOLDEN B A, FRICKE T R, WILSON D A, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042. doi: 10.1016/j.ophtha.2016.01.006
[5]	陶芳标. 学校—学生—学业联动是打好儿童青少年近视防控攻坚战的基石[J]. 中国学校卫生, 2019, 40(1): 3-6. doi: 10.16835/j.cnki.1000-9817.2019.01.002 TAO F B. School-student-academic interaction is the cornerstone of the prevention and control of myopia in children and adolescents[J]. Chin J Sch Health, 2019, 40(1): 3-6. doi: 10.16835/j.cnki.1000-9817.2019.01.002
[6]	张勇. 2018年全国儿童青少年近视调查[R]. 北京: 国家卫生健康委员会, 2019. ZHANG Y. Investigation on myopia of children and adolescents in China in 2018[R]. Beijing: National Health and Wellness Committee, 2019.
[7]	中南大学爱尔眼科学院. 2020中国青少年近视防控大数据报告[N]. 人民日报, 2020-09-10(006). Aier School of Ophthalmology, Central South University, 2020 big data report on prevention and control of myopia in Chinese adolescents[N]. People's Daily, 2020-09-10(006).
[8]	樊泽民, 刘芳丽, 刘立京, 等. 中国综合防控儿童青少年近视行动方兴未艾[J]. 中国学校卫生, 2019, 40(12): 1767-1770. doi: 10.16835/j.cnki.1000-9817.2019.12.002 FAN Z M, LIU F L, LIU L J, et al. China's comprehensive prevention and control of myopia among children and adolescents is in the ascendant[J]. Chin J Sch Health, 2019, 40(12): 1767-1770. doi: 10.16835/j.cnki.1000-9817.2019.12.002
[9]	LONG E P. Evolutionary medicine: why does prevalence of myopia significantly increase?[J]. Evolut Med Public Health, 2018, 2018(1): 151-152. doi: 10.1093/emph/eoy017
[10]	FRICKE T, HURAIRAH H, HUANG Y, et al. Pharmacological interventions in myopia management[J]. Commun Eye Health, 2019, 32: 21-22. http://www.ncbi.nlm.nih.gov/pubmed/31409953
[11]	WAKAYAMA A, NISHINA S, MIKI A, et al. Incidence of side effects of topical atropine sulfate and cyclopentolate hydrochloride for cycloplegia in Japanese children: a multicenter study[J]. J Ophthalmol, 2018, 62(5): 531-536. doi: 10.1007%2Fs10384-018-0612-7.pdf
[12]	WALLINE J J, LINDSLEY K B, VEDULA S S, et al. Interventions to slow progression of myopia in children[J]. Cochrane Database System Rev, 2020, 1. DOI: 10.1002/14651858.cd004916.pub3
[13]	YAM J C, JIANG Y, TANG S M, 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[J]. Ophthalmology, 2019, 126(1): 113-124. doi: 10.1016/j.ophtha.2018.05.029
[14]	AVETISOV S E, FISENKO V P, ZHURAVLEV A S, et al. Atropine use for the prevention of myopia progression[J]. Vestn Oftalmol, 2018, 134(4): 84-90. doi: 10.17116/oftalma201813404184
[15]	CHUA W H, Balakrishnan, et al. Atropine for the treatment of childhood myopia[J]. Ophthalmology, 2006, 113: 2285-2291. doi: 10.1016/j.ophtha.2006.05.062
[16]	LI F F, YAM J C. Low-concentration atropine eye drops for myopia progression[J]. Asia-Pacific J Ophthalmol, 2019, 8(5): 360-365. doi: 10.1097/APO.0000000000000256
[17]	CHIA A, Q-SS L, TAN D T H. Five-year clinical trial on atropine for the treatment of myopia 2 myopia control with atropine 0.01% eyedrops[J]. Ophthalmology, 2016, 123: 391-399. doi: 10.1016/j.ophtha.2015.07.004
[18]	YAM J C, LI F F, ZHANG X J, et al. Two-year clinical trial of the low-concentration atropine for myopia progression (LAMP) study: phase 2 report[J]. Ophthalmology, 2019. http://www.ncbi.nlm.nih.gov/pubmed/32019700
[19]	FANG P C, CHUNG M Y, YU H J, et al. Prevention of myopia onset with 0.025% atropine in premyopic children[J]. J Ocul Pharmacol Ther, 2010, 26(4): 341-345. doi: 10.1089/jop.2009.0135
[20]	KHANAL S, PHILLIPS J R. Which low-dose atropine for myopia control?[J]. Clin Experim Optom, 2020, 103(2): 230-232. doi: 10.1111/cxo.12967
[21]	CHIA A, CHUA W H, CHEUNG Y B, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2)[J]. Ophthalmology, 2012, 119(2): 347-354. doi: 10.1016/j.ophtha.2011.07.031
[22]	COOPER J, EISENBERG N, SCHULMAN E, et al. Maximum atropine dose without clinical signs or symptoms[J]. Optom Vis Sci, 2013, 90: 1467-1472. doi: 10.1097/OPX.0000000000000037
[23]	GONG Q, JANOWSKI M, LUO M, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis[J]. JAMA Ophthalmol, 2017, 135(6): 624-630. doi: 10.1001/jamaophthalmol.2017.1091
[24]	王勇, 姜波. 合肥城区进展性近视学龄儿童0.01%阿托品的疗效和安全性[J]. 中国学校卫生, 2021, 42(2): 173-176. doi: 10.16835/j.cnki.1000-9817.2021.02.004 WANG Y, JIANG B. Efficacy and safety of 0.01% atropine in school-age children with progressive myopia in Hefei[J]. Chin J Sch Health, 2021, 42(2): 173-176. doi: 10.16835/j.cnki.1000-9817.2021.02.004
[25]	JOACHIMSEN L, DANIEL B, GROSS N J, et al. A pilot study on the effcacy and safety of 0.01% atropine in German school-children with progressive myopia[J]. Ophthalmol Ther, 2019, 8(3): 427-433. doi: 10.1007/s40123-019-0194-6
[26]	AZUARA-BLANCO A, LOGAN N, STRANG N, et al. Low-dose (0.01%) atropine eye-drops to reduce progression of myopia in children: a multicentre placebo-controlled randomised trial in the UK (CHAMP-UK)-study protocol[J]. Br J Ophthalmol, 2020, 104(7): 950-955. doi: 10.1136/bjophthalmol-2019-314819
[27]	MATTEO S, MASSIMILIANO S, EDOARDO V, et al. Efficacy of atropine 0.01% for the treatment of childhood myopia in European patients[J]. Acta Ophthalmol, 2019, 97(8). http://www.ncbi.nlm.nih.gov/pubmed/31197953
[28]	DIAZ-LLOPIS M, PINAZO-DURÁN M D. Superdiluted atropine at 0.01% reduces progression in children and adolescents. a 5 year study of safety and effectiveness[J]. Arch Soc Esp Oftalmol, 2018, 93(4): 182-185. doi: 10.1016/j.oftal.2017.12.015
[29]	ZHAO C, CAI C, DING Q, et al. Efficacy and safety of atropine to control myopia progression: a systematic review and meta-analysis[J]. BMC Ophthalmol, 2020, 20(1): 478. doi: 10.1186/s12886-020-01746-w
[30]	李静一, 刘芙蓉, 周晓伟, 等. 0.01%阿托品对学龄期儿童近视防控作用研究[J]. 中国学校卫生, 2018, 39(3): 432-435. doi: 10.16835/j.cnki.1000-9817.2018.03.032 LI J Y, LIU F R, ZHOU X W, et al. Study on the effect of 0.01% atropine on the prevention and control of myopia in school-age children[J]. Chin J Sch Health, 2018, 39(3): 432-435. doi: 10.16835/j.cnki.1000-9817.2018.03.032
[31]	CLARK T Y, CLARK R A. Atropine 0.01% eyedrops significantly reduce the progression of childhood myopia[J]. J Ocul Pharmacol Ther, 2015, 31(9): 541-545. doi: 10.1089/jop.2015.0043
[32]	LOUGHMAN J, FLITCROFT D I. The acceptability and visual impact of 0.01% atropine in a Caucasian population[J]. Br J Ophthalmol, 2016, 100(11): 1525-1529. doi: 10.1136/bjophthalmol-2015-307861
[33]	SUN H Y, LU W Y, YOU J Y, et al. Peripheral refraction in myopic children with and without atropine usage[J]. J Ophthalmol, 2020: 4919154. DOI: 10.1155/2020/4919154.
[34]	SMITH E L 3rd, KEE C S, RAMAMIRTHAM R, et al. Peripheral vision can influence eye growth and refractive development in infant monkeys[J]. Invest Ophthalmol Vis Sci, 2005, 46(11): 3965-3972. doi: 10.1167/iovs.05-0445
[35]	LOH K L, LU Q, TAN D, et al. Risk factors for progressive myopia in the atropine therapy for myopia study[J]. Am J Ophthalmol, 2015, 159(5): 945-949. doi: 10.1016/j.ajo.2015.01.029
[36]	ZHANG X Y, WANG Y L, ZHOU X T, et al. Analysis of factors that may affect the effect of atropine 0.01% on myopia control[J]. Front Pharmacol, 2020, 11: 01081. doi: 10.3389/fphar.2020.01081
[37]	TONG L, HUANG X L, KOH A L, et al. Atropine for the treatment of childhood myopia: effect on myopia progression after cessation of atropine[J]. Ophthalmology, 2009, 116(3): 572-579. doi: 10.1016/j.ophtha.2008.10.020
[38]	CHIA A, CHUA W H, WEN L, et al. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%[J]. Am J Ophthalmol, 2014, 157(2): 451-457. doi: 10.1016/j.ajo.2013.09.020
[39]	符爱存, 赵兵新, 张俊杰, 等. 近视儿童应用0.01%硫酸阿托品滴眼液的不良反应[J]. 中华实验眼科杂志, 2018, 36(6): 449-453. doi: 10.3760/cma.j.issn.2095-0160.2018.06.010 FU A C, ZHAO B X, ZHANG J J, et al. Adverse reactions of 0.01% atropine sulfate eye drops in myopic children[J]. Chin J Experim Ophthalmol, 2018, 36(6): 449-453. doi: 10.3760/cma.j.issn.2095-0160.2018.06.010
[40]	WEN Q, FAN T J, TIAN C L. Cytotoxicity of atropine to human corneal endothelial cells by inducing mitochondrion-dependent apoptosis[J]. Exp Biol Med, 2016, 241(13): 1457-1465. doi: 10.1177/1535370216640931
[41]	FELDKAEMPER M, SCHAEFFEL F. An updated view on the role of dopamine in myopia[J]. Exp Eye Res, 2013, 114: 106-119. doi: 10.1016/j.exer.2013.02.007
[42]	CHIA-YI L, CHI-CHIN S, YI-FANG L, et al. Effects of topical atropine on intraocular pressure and myopia progression: a prospective comparative study[J]. BMC Ophthalmol, 2016, 16(1): 114. doi: 10.1186/s12886-016-0297-y
[43]	WU T E, YANG C C, CHEN H S. Does atropine use increase intraocular pressure in myopic children?[J]. Optom Vis Sci, 2012, 89(2): E161-E167. doi: 10.1097/OPX.0b013e31823ac4c1
[44]	薛雨顺, 李裕钦, 石蕊, 等. 青少年近视眼屈光度与眼轴长度及眼内压的相关性分析[J]. 国际眼科杂志, 2008(9): 1847-1849. https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK200809040.htm XUE Y S, LI Y Q, SHI R, et al. Correlation analysis of diopter with axial length and intraocular pressure in adolescent myopia[J]. Int J Ophthalmol, 2008(9): 1847-1849. https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK200809040.htm
[45]	HARRIS L S. Cycloplegic-induced intraocular pressure elevations a study of normal and open-angle glaucomatous eyes[J]. Arch Ophthalmol, 1968, 79: 242-246. doi: 10.1001/archopht.1968.03850040244004
[46]	陈辉. 毒蕈碱拮抗剂减缓近视发展的研究进展[J]. 中华实验眼科杂志, 2017, 35(6): 556-560. doi: 10.3760/cma.j.issn.2095-0160.2017.06.015 CHEN H. Research progress of muscarinic antagonists in slowing the development of myopia[J]. Chin J Exper Ophthalmol, 2017, 35(6): 556-560. doi: 10.3760/cma.j.issn.2095-0160.2017.06.015
[47]	朱依谆, 殷明. 药理学[M]. 8版. 北京: 人民卫生出版社, 2016: 75-78. ZHU Y C, YIN M. Pharmacology[M]. 8th Edition. Beijing: People's Health Publishing House, 2016: 75-78.
[48]	CHO W H, FANG P C, YU H J, et al. Analysis of tear film spatial instability for pediatric myopia under treatment[J]. Sci Rep, 2020, 10(1): 14789. doi: 10.1038/s41598-020-71710-7
[49]	ZHAO Q, HAO Q. Clinical efficacy of 0.01% atropine in retarding the progression of myopia in children[J]. Int Ophthalmol, 2020, 41(3): 1011-1017. doi: 10.1007/s10792-020-01658-0
[50]	MCBRIEN N A, STELL W K, CARR B, et al. How does atropine exert its anti-myopia effects?[J]. Ophthal Physiol Opt, 2013, 33(3): 373-378. doi: 10.1111/opo.12052
[51]	LI W, JIANG R, ZHU Y, et al. Effect of 0.01% atropine eye drops on choroidal thickness in myopic children[J]. J Fr Ophtalmol, 2020. DOI: 10-1016/j.jfo.2020.04.023.
[52]	MCBRIEN N A, JOBLING A I, TRUONG H T, et al. Expression of muscarinic receptor subtypes in tree shrew ocular tissues and their regulation during the development of myopia[J]. Mol Vis, 2009, 15: 464-475. http://europepmc.org/articles/PMC2649308?pdf=render
[53]	TIGGES M, IUVONE P M, FEMANDES A, et al. Efkcts of muscarinic cholinergic receptor antagonists on postnatal eye growth of rhesus monkeys[J]. Optom Vis Sci, 1999, 76(6): 397-407. doi: 10.1097/00006324-199906000-00020
[54]	SCHWAHN H N, KAYMAK H, SCHAEFFEL F. Effects of atropine on refractive development, dopamine release, and slow retinal potentials in the chick[J]. Vis Neurosci, 2000, 17(2): 165-176. doi: 10.1017/S0952523800171184
[55]	AYAJIKI K, TANAKA T, OKAMURA T, et al. Evidence for nitroxidergic innervation in monkey ophthalmic arteries in vivo and in vitro[J]. Am J Phys Heart Circ Physio, 2000, 279(4): H2006-H2012. doi: 10.1152/ajpheart.2000.279.4.H2006
[56]	SHIH Y F, CHEN C H, CHOU A C, et al. Effects of different concentrations of atropine on controlling myopia in myopic children[J]. Ocul Pharmacol Ther, 1999, 15: 85-90. doi: 10.1089/jop.1999.15.85
[57]	MAO J, LIU S, QIN W, et al. Levodopa inhibits the development of form-deprivation myopia in guinea pigs[J]. Optom Vis Sci, 2010, 87(1): 53-60. doi: 10.1097/OPX.0b013e3181c12b3d
[58]	ZHOU X, ZHANG S, ZHANG G Y, et al. Increased choroidal blood perfusion can inhibit form deprivation myopia in Guinea pigs[J]. Invest Ophthalmol Vis Sci, 2020, 61: 25. http://www.researchgate.net/publication/347064569_Increased_Choroidal_Blood_Perfusion_Can_Inhibit_Form_Deprivation_Myopia_in_Guinea_Pigs
[59]	HSIAO Y T, CHANG W A, KUO M T, et al. Systematic analysis of transcriptomic profile of the effects of low dose atropine treatment on scleral fibroblasts using next-generation sequencing and bioinformatics[J]. Inter J Med Sci, 2019, 16(12): 1652-1667. doi: 10.7150/ijms.38571
[60]	SCHITTKOWSKI M P, STURM V. Atropine for the prevention of progression in myopia-data, side effects, practical guidelines[J]. Klin Monbl Augenheilkd, 2018, 235(4): 385-391. doi: 10.1055/s-0043-121982
[61]	WU P C, CHUANG M N, CHOI J, et al. Update in myopia and treatment strategy of atropine use in myopia control[J]. Eye (Lond), 2019, 33(1): 3-13. doi: 10.1038/s41433-018-0139-7
[62]	康凯, 郑继伟. 复方托吡卡胺滴眼液与阿托品眼膏在治疗青少年假性近视中的对比研究[J]. 中外女性健康研究, 2017(10): 40-64. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWVJ201710027.htm KANG K, ZHENG J W. Comparative study of compound tropicamide eye drops and atropine eye ointment in the treatment of adolescent pseudomyopia[J]. Chin Foreign Women's Health Res, 2017(10): 40-64. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWVJ201710027.htm
[63]	李鹏. 阿托品眼用凝胶在儿童延缓近视中的应用[J]. 中国斜视与小儿眼科杂志, 2015, 23(3): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS201503015.htm LI P. Application of atropine ophthalmic gel in delaying myopia in children[J]. Chin J Strabism Pediatr Ophthalmol, 2015, 23(3): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS201503015.htm