Relative peripheral refraction (RPR) is a significant factor that participates in myopic development. Here, we evaluated the effects of atropine 0.01% eyedrops, as an antimyopia drug, on RPR.
Seventy-three children were enrolled from a randomized, double-blinded, placebo-0.01% atropine eyedrops cross-over trial. The study group had used the placebo for one year and then crossed over to atropine 0.01% eyedrops for half a year. The control group had used 0.01% atropine for one year and then crossed over to placebo eyedrops for half a year. Central and horizontal peripheral refractions (15° and 30° at the temporal and nasal retina) were measured under non-cycloplegia and cycloplegia.
No significant differences in age, gender, and central refraction were identified between the two groups (P > 0.05). Under non-cycloplegia, the control group showed significant relative hyperopia in the temporal 30° retina and the nasal retina (P = 0.031; P < 0.001; P < 0.001). In the study group, the relative hyperopia in the temporal 30° retina disappeared (P = 0.983). After cycloplegia, the control group had less myopia in central refractions and less hyperopia in temporal RPR (P < 0.001; P = 0.039; P < 0.001). The study group did not present significant changes in central refractions and temporal RPR (P = 0.122; P = 0.222; P = 0.475).
For myopic children, atropine 0.01% eyedrops can alleviate relative hyperopia in the temporal retina and the hyperopic shift before cycloplegia. The effect might participate in myopia control.
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Holden B, Fricke T, Wilson D, Jong M, Naidoo K, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036–42.
Wei S, Sun Y, Li S, Hu J, Yang X, Lin C, et al. Refractive errors in University Students in Central China: the Anyang University students eye study. Invest Ophthalmol Vis Sci. 2018;59:4691–700.
Quek T, Chua C, Chong C, Chong J, Hey H, Lee J, et al. Prevalence of refractive errors in teenage high school students in Singapore. Ophthalmic Physiol Opt. 2004;24:47–55.
Gimbel H. The control of myopia with atropine. Can J Ophthalmol. 1973;8:527–32.
Yen M, Liu J, Kao S, Shiao C. Comparison of the effect of atropine and cyclopentolate on myopia. Ann Ophthalmol. 1989;21:180–2.
Chia A, Chua W, Wen L, Fong A, Goon Y, Tan D. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%. Am J Ophthalmol. 2014;157:451–7.
Gong Q, Janowski M, Luo M, Wei H, Chen B, Yang G, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis. JAMA Ophthalmol. 2017;135:624–30.
Faria-Ribeiro M, Queirós A, Lopes-Ferreira D, Jorge J, González-Méijome J. Peripheral refraction and retinal contour in stable and progressive myopia. Optom Vis Sci. 2013;90:9–15.
Hoogerheide J, Rempt F, Hoogenboom W. Acquired myopia in young pilots. Ophthalmologica. 1971;163:209–15.
Smith E, Kee C, Ramamirtham R, Qiao-Grider Y, Hung L. Peripheral vision can influence eye growth and refractive development in infant monkeys. Invest Ophthalmol Vis Sci. 2005;46:3965–72.
Irving E, Yakobchuk-Stanger C. Myopia progression control lens reverses induced myopia in chicks. Ophthalmic Physiol Opt. 2017;37:576–584.
Kang P, Swarbrick H. Peripheral refraction in myopic children wearing orthokeratology and gas-permeable lenses. Optom Vis Sci. 2011;88:476–482.
Sankaridurg P, He X, Naduvilath T, Lv M, Ho A, Smith E, et al. Comparison of noncycloplegic and cycloplegic autorefraction in categorizing refractive error data in children. Acta Ophthalmol. 2017;95:e633–e640.
Lin Z, Vasudevan B, Ciuffreda K, Zhou H, Mao G, Wang N, et al. The difference between cycloplegic and non-cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children. Ophthalmic Physiol Opt. 2017;37:489–97.
Zhao J, Mao J, Luo R, Li F, Pokharel G, Ellwein L. Accuracy of noncycloplegic autorefraction in school-age children in China. Optom Vis Sci. 2004;81:49–55.
Wei S, Li S, An W, Du J, Liang X, Sun Y, et al. Safety and efficacy of low-dose atropine eyedrops for the treatment of myopia progression in chinese children: a randomized clinical trial. JAMA Ophthalmol. 2020;138:1178–84.
Thibos L, Wheeler W, Horner D. Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error. Optom Vis Sci. 1997;74:367–75.
Radhakrishnan H, Allen P, Calver R, Theagarayan B, Price H, Rae S, et al. Peripheral refractive changes associated with myopia progression. Invest Ophthalmol Vis Sci. 2013;54:1573–81.
Li S, Li S, Liu L, Zhou Y, Yang Z, Kang M, et al. Peripheral refraction in 7- and 14-year-old children in central China: the Anyang Childhood Eye Study. Br J Ophthalmol. 2015;99:674–79.
Flitcroft D. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31:622–60.
Mallen E, Kashyap P. Technical note: measurement of retinal contour and supine axial length using the Zeiss IOLMaster. Ophthalmic Physiol Opt. 2007;27:404–11.
Schmid G. Association between retinal steepness and central myopic shift in children. Optom Vis Sci. 2011;88:684–90.
Verkicharla P, Mathur A, Mallen E, Pope J, Atchison D. Eye shape and retinal shape, and their relation to peripheral refraction. Ophthalmic Physiol Opt. 2012;32:184–99.
Rynders M, Lidkea B, Chisholm W, Thibos LN. Statistical distribution of foveal transverse chromatic aberration, pupil centration, and angle psi in a population of young adult eyes. J Opt Soc Am A Opt Image Sci Vis. 1995;12:2348–57.
Pande M, Hillman JS. Optical zone centration in keratorefractive surgery. Entrance pupil center, visual axis, coaxially sighted corneal reflex, or geometric corneal center? Ophthalmology. 1993;100:1230–7.
Niyazmand H, Read S, Atchison D, Collins M. Anterior eye shape in emmetropes, low to moderate myopes, and high myopes. Cont Lens Anterior Eye. 2021;44:101361.
Fadel D. The influence of limbal and scleral shape on scleral lens design. Cont Lens Anterior Eye. 2018;41:321–28.
Consejo A, Llorens-Quintana C, Bartuzel M, Iskander D. Rozema. J Rotat asymmetry Hum sclera Acta Ophthalmol. 2019;97:e266–e270.
Ritzmann M, Caroline P, Börret R, Korszen E. An analysis of anterior scleral shape and its role in the design and fitting of scleral contact lenses. Cont Lens Anterior Eye. 2018;41:205–13.
Kaufman P, Lütjen Drecoll E, Croft M. Presbyopia and glaucoma: two diseases, one pathophysiology? The 2017 Friedenwald lecture. Invest Ophthalmol Vis Sci. 2019;60:1801–12.
Stone R, Pendrak K, Sugimoto R, Lin T, Gill A, Capehart C, et al. Local patterns of image degradation differentially affect refraction and eye shape in chick. Curr Eye Res. 2006;31:91–105.
Sun H, Lu W, You J, Kuo H. Peripheral refraction in myopic children with and without atropine usage. J Ophthalmol. 2020;2020:4919154.
Lan W, Lin Z, Yang Z, Artal P. Two-dimensional peripheral refraction and retinal image quality in emmetropic children. Sci Reps. 2019;9:16203.
Campbell F, Westheimer G. Dynamics of accommodation responses of the human eye. J Physiol. 1960;151:285–95.
Ciuffreda K, Vasudevan B. Nearwork-induced transient myopia (NITM) and permanent myopia–is there a link? Ophthalmic Physiol Opt. 2008;28:103–14.
Guo L, Fan L, Tao J, Hua R, Yang Q, Gu H, et al. Use of topical 0.01% atropine for controlling near work-induced transient myopia: a randomized, double-masked, placebo-controlled study. J Ocul Pharm Ther. 2020;36:97–101.
Loughman J, Flitcroft D. The acceptability and visual impact of 0.01% atropine in a Caucasian population. Br J Ophthalmol. 2016;100:1525–9.
Yam J, Jiang Y, Tang S, Law A, Chan J, Wong E, 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. Ophthalmology. 2019;126:113–24.
Chiang S, Phillips J. Effect of atropine eye drops on choroidal thinning induced by hyperopic retinal defocus. J Ophthalmol. 2018;2018:8528315.
Sander B, Collins M, Read S. Short-term effect of low-dose atropine and hyperopic defocus on choroidal thickness and axial length in young myopic adults. J Ophthalmol. 2019;2019:4782536.
Wu H, Chen W, Zhao F, Zhou Q, Reinach P, Deng L, et al. Scleral hypoxia is a target for myopia control. Proc Natl Acad Sci USA. 2018;115:E7091–E7100.
Benavente-Pérez A, Nour A, Troilo D. Axial eye growth and refractive error development can be modified by exposing the peripheral retina to relative myopic or hyperopic defocus. Invest Ophthalmol Vis Sci. 2014;55:6765–73.
Berntsen D, Barr C, Mutti D, Zadnik K. Peripheral defocus and myopia progression in myopic children randomly assigned to wear single vision and progressive addition lenses. Invest Ophthalmol Vis Sci. 2013;54:5761–70.
Rotolo M, Montani G, Martin R. Myopia onset and role of peripheral refraction. Clin Optpm. 2017;9:105–11.
Atchison DA, Li SM, Li H, Li SY, Liu LR, Kang MT, et al. Relative peripheral hyperopia does not predict development and progression of myopia in children. Invest Ophthalmol Vis Sci. 2015;56:6162–70.
The authors thank support and help from Beijing Tongren Hospital, Capital Medical University.
The work was supported by Beihang University-CMU, Advanced Innovation Center for Big Data-Based Precision Medicine, Ophthalmic subcenter and Sanming Project of Medicine in Shenzhen (No. SZSM201512045).
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Tian, J., Wei, S., Li, S. et al. The effect of atropine 0.01% eyedrops on relative peripheral refraction in myopic children. Eye 37, 356–361 (2023). https://doi.org/10.1038/s41433-021-01923-1