For a study, researchers sought to compare the efficacy of continuing and discontinuing therapy for 0.05, 0.025, and 0.015% atropine throughout the third year. To assess the effectiveness of ongoing therapy over a three-year period. To explore the rebound phenomena and its factors following treatment discontinuation. About 350 of the 438 children enrolled in the Low-Concentration Atropine for Myopia Progression (LAMP) trial were aged 4 to 12 years. At the start of the third year, children in each group were randomly assigned to one of two subgroups: continuing therapy or washout. At 4-month intervals, cycloplegic spherical equivalent (SE) refraction and axial length (AL) were assessed.
After three years of follow-up was completed by 326 youngsters. Across all concentrations, SE advancement and AL elongation were quicker in the washout subgroups during the third year than in the continued treatment groups: –0.68±0.49 diopters (D) vs –0.28±0.42 D (P<0.001) and 0.33±0.17 mm versus 0.17 0.14 mm (P<0.001) for the 0.05%; –0.57 0.38 D versus –0.35±0.37 D (P=0.004) and 0.29±0.14 mm versus 0.20±0.15 mm (P=0.001) for the 0.025%;–0.56 ± 0.40 D versus –0.38 ± 0.49 D (P=0.04) and 0.29 ± 0.15 mm versus 0.24 ± 0.18 mm (P=0.13) for the 0.01%. SE progressions were –0.73±1.04 D, –1.31±0.92 D, and –1.60±1.32 D (P=0.001) for the 0.05%, 0.025%, and 0.01% groups in the continuing treatment subgroups, respectively, and 1.15±1.13 D, –1.47±0.77 D, and –1.81±1.10 D (P=0.03) in the washout subgroup. The corresponding AL elongations for the continuing treatment subgroups were 0.50±0.40 mm, 0.74±0.41 mm, and 0.89±0.53 mm (P<0.001) and 0.70±0.47 mm, 0.82 ±0.37 mm, and 0.98 ±0.48 mm (P=0.04). The concentration-dependent rebound SE progressions following washout were clinically insignificant (P=0.15). In both SE progression (P<0.001) and AL elongation (P<0.001), older age and lower concentration were linked with smaller rebound effects.
Compared to the washout regimen, continuing atropine administration had a stronger impact across all concentrations throughout the third year. Over a three-year period, 0.05% atropine maintained the ideal concentration in youngsters. The variations in rebound effects were clinically insignificant across all three atropine doses investigated. Treatment discontinuation at an older age and at a lower concentration was related to a lesser recovery.
Reference:www.aaojournal.org/article/S0161-6420(21)00745-4/fulltext
