Is 0.01% Atropine an Effective and Safe Treatment for Myopic Children? A Systemic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Search Strategy
2.3. Inclusion and Exclusion Criteria
2.4. Data Extraction
2.5. Quality Assessment
2.6. Data Synthesis and Statistical Analyses
3. Results
3.1. Search Results
3.2. Study Characteristics
3.3. Risk of Bias Assessment
3.4. Pooled Effects of the Efficacy Outcome
3.4.1. Spherical Equivalent Refractive Error
3.4.2. Axial Length
3.5. Pooled Effects of the Safety Outcome
3.5.1. Accommodative Amplitude
3.5.2. Photopic Pupil Diameter
3.5.3. Mesopic Pupil Diameter
3.6. Modified Hartung–Knapp–Sidik–Jonkman (HKSJ) Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study (Author, Year) | Country | Study Design | Study Population | Follow- Up, yr | Intervention | Number of Eyes | Mean Age (SD), yr | Mean Baseline Refraction (SD), D | Mean Baseline Axial Length (SD), mm | Drop-Out Rate |
---|---|---|---|---|---|---|---|---|---|---|
Clark 2015 | United states | Retrospective Case-control | Multi-ethnicity | 1.1 (0.3) | Placebo 0.01% atropine | 28 28 | 10.2 (2.2) 10.2 (2.2) | −2.0 (1.5) −2.0 (1.6) | NA NA | NA NA |
Fu 2020 | China | RCT | Asian | 1 | Placebo 0.01% atropine | 100 119 | 9.5 (1.4) 9.3 (1.9) | −2.68 (1.42) −2.70 (1.64) | 24.55 (0.71) 24.58 (0.74) | 20/120 23/142 |
Heida 2021 | Japan | RCT | Asian | 2 | Placebo 0.01% atropine | 80 * 78 * | 8.98 (1.50) 8.99 (1.44) | R/L: −2.96 (1.24)/ −2.97 (1.22) R//L: −2.92 (1.43)/ −2.90 (1.38) | R:/L: 24.50 (0.69)/ 24.48 (0.70) R:/L: 24.41 (0.86)/ 24.40 (0.87) | 6/86 * 7/85 * |
Larkin 2019 | United states | Retrospective Case-control | Multi-ethnicity | 2 | Placebo 0.01% atropine | 98 100 | 9.2 (2.11) 9.3 (2.10) | −2.8 (1.6) −3.1 (1.9) | NA NA | NA NA |
Saxena 2021 | India | RCT | Asian | 1 | Placebo 0.01% atropine | 45 47 | 10.8 (2.2) 10.6 (2.2) | −3.71 (1.37) −3.38 (1.32) | 24.70 (0.80) 24.60 (1.02) | 5/50 3/50 |
Sacchi 2019 | Italy | Retrospective Cohort | European | 1 | Placebo 0.01% atropine | 50 52 | 12.1 (2.9) 9.7 (2.3) | −2.63 (2.68) −3.00 (2.23) | NA NA | NA NA |
Wei 2020 | China | RCT | Asian | 1 | Placebo 0.01% atropine | 83 76 | 9.84 (1.53) 9.44 (1.80) | −2.64 (1.46) −2.52 (1.33) | 24.69 (0.97) 24.50 (0.76) | 27/110 34/110 |
Yam 2019 | Hong Kong | RCT | Asian | 1 | Placebo 0.01% atropine | 93 97 | 8.42 (1.72) 8.23 (1.83) | −3.85 (1.95) −3.77 (1.85) | 24.82 (0.97) 24.70 (0.99) | 18/111 13/110 |
Standardized Equivalent Refraction (SER) | ||||
---|---|---|---|---|
Subgroups | No. of Studies | Pooled MD (95% CI) | p-Value | I2 (%) |
Overall | 8 | 0.28 (0.17 to 0.38) | <0.01 ** | 71.4 |
Study design | ||||
RCTs | 5 | 0.18 (0.11 to 0.26) | <0.01 ** | 38.5 |
Non-RCTs | 3 | 0.46 (0.34 to 0.59) | <0.01 ** | 0.0 |
Study population | ||||
Asian only | 5 | 0.18 (0.11 to 0.26) | <0.01 ** | 38.5 |
European only | 1 | 0.55 (0.31 to 0.79) | <0.01 ** | - |
Multi-ethnicity | 2 | 0.43 (0.28 to 0.58) | <0.01 ** | 0.0 |
Mean age, year | ||||
Age < 10 | 5 | 0.23 (0.12 to 0.34) | <0.01 ** | 67.5 |
Age > 10 | 3 | 0.40 (0.15 to 0.65) | <0.01 ** | 73.9 |
Mean baseline refraction, Diopter | ||||
>−3.00 | 6 | 0.31 (0.17 to 0.46) | <0.01 ** | 79.4 |
<−3.00 | 2 | 0.20 (0.09 to 0.32) | <0.01 ** | 0.0 |
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Tsai, H.-R.; Chen, T.-L.; Wang, J.-H.; Huang, H.-K.; Chiu, C.-J. Is 0.01% Atropine an Effective and Safe Treatment for Myopic Children? A Systemic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 3766. https://doi.org/10.3390/jcm10173766
Tsai H-R, Chen T-L, Wang J-H, Huang H-K, Chiu C-J. Is 0.01% Atropine an Effective and Safe Treatment for Myopic Children? A Systemic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(17):3766. https://doi.org/10.3390/jcm10173766
Chicago/Turabian StyleTsai, Hou-Ren, Tai-Li Chen, Jen-Hung Wang, Huei-Kai Huang, and Cheng-Jen Chiu. 2021. "Is 0.01% Atropine an Effective and Safe Treatment for Myopic Children? A Systemic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 17: 3766. https://doi.org/10.3390/jcm10173766