Atropine and Orthokeratology combo Shows Promise in Myopia Control in Children

A comprehensive study exploring the effectiveness of atropine, orthokeratology (ortho-k), and their combined treatment over a span of 2 years has revealed promising results in controlling myopia progression in children aged 8–12 years. The research, conducted through a randomized controlled trial, aimed to not only assess the efficacy of these treatments individually but also investigate the influence of various factors on their effectiveness. This study was published in BMJ Ophthalmology by Shengsong Xu and colleagues.

The axial elongation, a key marker of myopia progression, exhibited a significant reduction across all interventions at various visits over the 2-year period (all p<0.05). When comparing the efficacy of combined treatment against monotherapies, a notable improvement was observed, indicating a potential synergistic effect in controlling myopia progression.

Further stratification by age groups highlighted an age-dependent impact on treatment efficacy. The subgroup aged 8–10 showed a closer efficacy between combined treatment and ortho-k, while in the 10–12 age group, the efficacy between combined treatment and atropine became less pronounced. This age-dependent effect was particularly significant in the ortho-k group versus both the control and atropine groups, suggesting that ortho-k might yield better results in younger children.

The study established that all interventions—placebo drops with spectacles (control), 0.01% atropine with spectacles (atropine), ortho-k with placebo, and the combined treatment—significantly curbed axial elongation throughout the 2-year period. Notably, the combined treatment demonstrated a significantly superior reduction in axial elongation compared to monotherapies. Additionally, an age-dependent effect was observed, suggesting that younger children, specifically in the age group of 8–10, might benefit more from ortho-k treatment.

The study underscores the potential benefits of combining atropine and ortho-k in managing myopia in children aged 8–12. Moreover, the age-stratified analysis suggests that younger children may derive more substantial benefits from ortho-k treatment.

These findings offer valuable insights into personalized myopia management strategies, emphasizing the importance of considering age-specific treatments for optimal efficacy. However, further research and longitudinal studies are necessary to validate these findings and establish definitive guidelines for tailored myopia interventions in pediatric populations.

Reference:

Xu, S., Li, Z., Zhao, W., Zheng, B., Jiang, J., Ye, G., Feng, Z., Long, W., He, L., He, M., Hu, Y., & Yang, X. Effect of atropine, orthokeratology and combined treatments for myopia control: a 2-year stratified randomised clinical trial. The British Journal of Ophthalmology,2023;107(12):1812–1817. https://doi.org/10.1136/bjo-2022-321272