Appropriate atropine dose and formulation without clinical signs or symptoms

doi:10.3877/cma.j.issn.2095-2007.2019.04.004

Abstract

Abstract:

Objective

The aim of this study was to explore the appropriate concentration and better formulation of atropinethat can be prescribed for controlling children myopia progression without significantly clinical visual symptoms, pupillary dilation and accommodative paralysis.

Methods

This was a randomized controlled trial with ten subjects (20 eyes) of spherical equivalent from -0.5 D to -5.0 D included. Subjects with brown iris were recruited from Beijing Tongren Hospital, in February 2017. Two of them are men and the average age is (24.8±0.79), ranging from 24 to 26 years. Atropine of 0.005%, 0.01%, 0.025% and 0.05% were administered to each subject successively. One eye was randomly given atropine eye drops with the contralateral eye gel. Ocular examinations included near visual acuity, accommodative amplitude and pupil size. Questionnaires were used to record subjects' visual symptoms. Multiple-factor repetitive measurement and analysis was used to compare the effects of different dosages and formulations on accommodative amplitude, pupil size and near visual acuity.

Results

Our results suggested that at all dosages of atropine eye drop and gel, there was certain degree of pupillary dilationand reduction in accommodative amplitudeand the effects became larger with higher dosages. Meanwhile, there was no significant difference between the dosages of 0.005%, 0.01% and 0.025% in accommodative amplitude (F=0.27, 3.28, 0.82; P>0.05), near visual acuity (F=0.14, 0.29, 0.57; P>0.05) and pupil size (F=1.70, 4.38, 0.92; P>0.05), with only the effect on pupil size larger for atropine eye gel than atropine eye drops (F=7.51, P<0.05). Subjects' complaints disappear with clinically acceptable findings for dosage of 0.005%, 0.01% and 0.025%, while 0.05% atropine presents the highest scores and toxic effects.

Conclusions

Atropine 0.025% might be the appropriate concentration to control myopia progression without significantly clinical symptoms both subjectively and objectively. What′s more, the side-effects of both formulationsare acceptable without significant differences between them.

Key words: Myopia, Atropine, Visual acuity, Accommodative amplitude, Pupil size

Yunyun Sun, Shiming Li, Mengtian Kang, Dayong Bai, Xiaoxia Peng, Ningli Wang. Appropriate atropine dose and formulation without clinical signs or symptoms[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(04): 212-217.

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References 32

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剂型与浓度	眼数	时间
剂型与浓度	眼数	基线	30 min	60 min	90 min	120 min	24 h
阿托品滴眼液
0.005%	10	5.25±0.79	5.55±0.84	6.41±0.83	6.67±0.86	6.77±0.76	6.05±0.77
0.01%	10	5.34±0.83	6.20±0.79	6.70±0.77	7.00±0.53	6.90±0.57	6.18±0.69
0.025%	10	5.49±0.78	6.81±0.78	7.22±0.70	7.36±0.65	7.35±0.62	6.79±0.80
0.05%	10	6.39±0.79	7.10±0.62	6.39±0.79	7.40±0.55	7.54±0.50	6.99±0.71
阿托品凝胶
0.005%	10	5.44±0.96	6.03±0.64	6.89±0.66	7.07±0.63	7.16±0.61	6.47±0.62
0.01%	10	5.65±0.71	6.77±0.72	7.24±0.52	7.39±0.45	7.51±0.48	6.97±0.72
0.025%	10	5.97±0.87	7.07±0.63	7.34±0.47	7.47±0.49	7.42±0.45	7.26±0.65
0.05%	10	6.80±0.67	7.34±0.45	7.54±0.39	7.56±0.43	7.57±0.43	7.38±0.44

剂型与浓度	眼数	时间
剂型与浓度	眼数	基线	30 min	60 min	90 min	120 min	24 h
阿托品滴眼液
0.005%	10	5.25±0.79	5.55±0.84	6.41±0.83	6.67±0.86	6.77±0.76	6.05±0.77
0.01%	10	5.34±0.83	6.20±0.79	6.70±0.77	7.00±0.53	6.90±0.57	6.18±0.69
0.025%	10	5.49±0.78	6.81±0.78	7.22±0.70	7.36±0.65	7.35±0.62	6.79±0.80
0.05%	10	6.39±0.79	7.10±0.62	6.39±0.79	7.40±0.55	7.54±0.50	6.99±0.71
阿托品凝胶
0.005%	10	5.44±0.96	6.03±0.64	6.89±0.66	7.07±0.63	7.16±0.61	6.47±0.62
0.01%	10	5.65±0.71	6.77±0.72	7.24±0.52	7.39±0.45	7.51±0.48	6.97±0.72
0.025%	10	5.97±0.87	7.07±0.63	7.34±0.47	7.47±0.49	7.42±0.45	7.26±0.65
0.05%	10	6.80±0.67	7.34±0.45	7.54±0.39	7.56±0.43	7.57±0.43	7.38±0.44

剂型与浓度	眼数	时间
剂型与浓度	眼数	基线	30 min	60 min	90 min	120 min	24 h
阿托品滴眼液
0.005%	10	1.40±0.34	1.46±0.64	1.42±0.40	1.26±0.59	1.45±0.41	1.44±0.52
0.01%	10	1.44±0.58	1.44±0.44	1.60±0.35	1.51±0.33	1.52±0.60	1.39±0.45
0.025%	10	1.42±0.30	1.27±0.70	1.36±0.57	1.30±0.47	1.40±0.37	1.27±0.44
0.05%	10	1.34±0.44	1.11±0.43	1.01±0.53	0.90±0.66	0.94±0.58	1.00±0.72
阿托品凝胶
0.005%	10	1.44±0.39	1.41±0.56	1.21±0.47	1.33±0.50	1.26±0.45	1.19±0.39
0.01%	10	1.26±0.40	1.21±0.44	1.14±0.43	1.02±0.64	1.19±0.42	1.04±0.42
0.025%	10	1.29±0.78	1.16±0.75	1.06±0.59	1.09±0.60	1.09±0.57	1.06±0.66
0.05%	10	1.09±0.62	0.71±0.69	0.60±0.62	0.54±0.54	0.75±0.44	0.80±0.62

剂型与浓度	眼数	时间
剂型与浓度	眼数	基线	30 min	60 min	90 min	120 min	24 h
阿托品滴眼液
0.005%	10	1.40±0.34	1.46±0.64	1.42±0.40	1.26±0.59	1.45±0.41	1.44±0.52
0.01%	10	1.44±0.58	1.44±0.44	1.60±0.35	1.51±0.33	1.52±0.60	1.39±0.45
0.025%	10	1.42±0.30	1.27±0.70	1.36±0.57	1.30±0.47	1.40±0.37	1.27±0.44
0.05%	10	1.34±0.44	1.11±0.43	1.01±0.53	0.90±0.66	0.94±0.58	1.00±0.72
阿托品凝胶
0.005%	10	1.44±0.39	1.41±0.56	1.21±0.47	1.33±0.50	1.26±0.45	1.19±0.39
0.01%	10	1.26±0.40	1.21±0.44	1.14±0.43	1.02±0.64	1.19±0.42	1.04±0.42
0.025%	10	1.29±0.78	1.16±0.75	1.06±0.59	1.09±0.60	1.09±0.57	1.06±0.66
0.05%	10	1.09±0.62	0.71±0.69	0.60±0.62	0.54±0.54	0.75±0.44	0.80±0.62

剂型与浓度	眼数	时间
剂型与浓度	眼数	基线	30 min	60 min	90 min	120 min	24 h
阿托品滴眼液
0.005%	10	-0.01±0.05	-0.05±0.05	-0.04±0.05	-0.03±0.05	-0.03±0.04	-0.08±0.05
0.01%	10	-0.05±0.04	-0.04±0.04	-0.03±0.04	-0.04±0.04	-0.05±0.05	-0.03±0.01
0.025%	10	-0.04±0.05	-0.09±0.06	-0.08±0.05	-0.06±0.06	-0.07±0.05	-0.03±0.08
0.05%	10	-0.05±0.08	-0.01±0.14	0.04±0.16	0.03±0.14	0.01±0.17	-0.01±0.12
阿托品凝胶
0.005%	10	-0.02±0.05	-0.04±0.05	-0.03±0.06	-0.04±0.05	-0.01±0.05	-0.07±0.07
0.01%	10	-0.06±0.04	-0.03±0.07	0.00±0.04	-0.03±0.06	-0.05±0.08	-0.02±0.05
0.025%	10	-0.06±0.05	-0.06±0.06	-0.07±0.06	-0.04±0.05	-0.05±0.05	-0.02±0.07
0.05%	10	-0.05±0.05	0.05±0.14	0.06±0.15	0.10±0.15	0.09±0.14	0.09±0.12

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