For a study, researchers sought to compare the effectiveness and safety of various atropine concentrations for myopia management. Atropine is recognized to be an effective medication for delaying the advancement of myopia. Nonetheless, no well-supported data exists to date to rate the clinical outcomes of varied atropine concentrations. On April 14, 2021, they searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. They chose trials using atropine administration for at least a year in children for myopia control. They examined 8 atropine doses in a network meta-analysis (NMA) of randomized controlled trials (RCTs) (1% to 0.01%). By P score, they ordered the atropine concentrations for the related outcomes (estimate of the probability of being the best treatment). The mean yearly changes in refraction (diopters/year) and axial length (AXL; millimeters/year) were the primary objectives. They gathered information on the proportion of eyes with myopia progression and safety results (photopic and mesopic pupil diameter, accommodation amplitude, distance, and near best-corrected visual acuity [BCVA]).
About 30 pairwise comparisons were gathered from 16 RCTs (3,272 individuals). The NMA identified the 1%, 0.50%, and 0.05% atropine concentrations as the three most helpful for myopia management, as measured by both primary outcomes: 1% atropine (mean differences compared to control: refraction, 0.81 [95% CI, 0.58–1.04]; AXL, –0.35 [–0.46 to –0.25]); 0.5% atropine (mean differences compared to control: refraction, 0.70 [95% CI, 0.40–1.00]; AXL, –0.23 [–0.38 to –0.07]); 0.05% atropine (me In terms of myopia management, the most favorable concentration was 0.05% (RR, 0.39 [95% CI, 0.27–0.57]). The chance of ill effects rose as atropine concentration increased, while the trend was not visible for distance BCVA. There was no meaningful network built near BCVA. The ranking likelihood for effectiveness was not dose-related (0.05% atropine was equivalent to high-dose atropine [1% and 0.5%]), but it was for pupil size and accommodation amplitude.
Reference:www.aaojournal.org/article/S0161-6420(21)00817-4/fulltext
