Differences in participant race, ethnicity may contribute to conflicting trial findings
Treating U.S. children with an investigational low-dose (0.01%) formulation of atropine eye drops didn't delay worsening of nearsightedness, a randomized clinical trial found. Over 24 months, kids using the once-nightly drops and those using placebo saw mean changes in spherical equivalent refractive error (SER) of -0.82 D (95% CI -0.96 to -0.68 D) and -0.80 D (95% CI -0.98 to -0.62 D), respectively, reported Michael Repka, MD, MBA, of the Jaeb Center for Health Research in Tampa, Florida, and colleagues. There still wasn't a significant difference in average SER change between the medicated drops and placebo by month 30, which included the on-treatment period plus 6-months post-treatment (adjusted difference -0.04 D, 95% CI -0.25 to +0.17 D). As a result, the findings "do not support the nightly use of low-dose atropine, 0.01%, eye drops to slow myopia progression in U.S. children," they wrote in JAMA Ophthalmology. At both the 24-month and 30-month marks, there were no significant differences between the atropine and placebo drops in regards to axial length changes (adjusted change of 0.44 mm at 24 mo. and 0.51 mm at 30 mo. for atropine versus 0.45 mm and 0.49 mm for placebo, respectively). Of note, the findings were consistent across all study sub-groups when stratified by age, sex, race and ethnicity, eye color, and baseline SER. "Physicians prescribing myopia control should not overstate the value of the treatment, as well as consider other concentrations," Repka told MedPage Today in an email. "The problem with changing drop strength is there is no adequately powered [data] here in the U.S." Atropine eye drops at higher strengths (0.5%-1.0%) have been used for decades to slow myopia progression, the researchers explained. While effective, these higher strengths have been associated with side effects including photophobia and blurred near vision. These results contrast with those of several previous trials, which have shown that different doses of…