Treatment effect and safety of low dose atropine eye drop for reducing myopia progression in children

2018 Fiscal Year Final Research Report

• Project/Area Number: 26462655
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Ophthalmology
• Research Institution: Kawasaki Medical School
• Principal Investigator: Hasebe Satoshi 川崎医科大学, 医学部, 教授 (20263577)
• Project Period (FY): 2014-04-01 – 2019-03-31
• Keywords: 近視 / 小児 / 予防治療 / 眼軸長 / 調節

Outline of Final Research Achievements

Atropine eye drop (At.) is known to reduce myopia progression. In this study, we studied the treatment effects and side effects produced by diluted (0.01%) At.in Japanese children with myopia. After applying of 0.01% At, subjective measurements of accommodative lag and pupillary diameter showed that accuracy of accommodation was well preserved but the pupils were slightly dilated, indicating the possibility of photophobia during outdoor activity. Mean myopia progression for 2 years was -1.43 and -1.52D for treated and control groups, respectively. Mean elongation of ocular axial length was 0.67 and 0.70mm for treated and control groups, respectively. The mean treatment effects (0.09D and 0.03mm) were not significant. These results suggested that 0.01% At. is ineffective or the effect is small as a clinical treatment and thus cannot to be recommended to children as a preventive treatment for myopia progression.

Free Research Field

眼科学

Academic Significance and Societal Importance of the Research Achievements

シンガポール国立眼研究所の報告（ATOM2）以来、国内でも多数の診療所で0.01%アトロピン点眼液(At.)が個人輸入され、学童期の近視進行予防治療と称して処方されるに至っている。ATOM2の対照データは過去の論文を借用したものであり、眼軸長伸展には抑制効果がなかったことから、結果を疑問視する研究者も少なくなかった。2018年に0.01%At.を用いた初のランダム化比較試験(LAMP study)が報告され、当初予測より効果はかなり小さいことが明らかになった。今回の結果はこの報告を裏付けるものであり、0.01%At.が近視進行予防治療として推奨できない事を示し、社会に警鐘を鳴らすことができた。