• Pediatric Ophth/Strabismus

    Review of: Two-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study

    Yam J, Li F, Zhang X, et al. Ophthalmology, July 2020

    This 2-year study compared the efficacy and safety of 3 concentrations of atropine eye drops to determine the optimal concentration for long-term myopia control.

    Study design

    This randomized, double-masked trial extended from the Low-Concentration Atropine for Myopia Progression (LAMP) Study and included 383 children aged 4 to 12 years with myopia of at least -1.0 D. During phase 1, patients were originally randomized to receive atropine 0.05%, 0.025%, 0.01% or placebo once daily in both eyes. In this phase 2 extension trial, children in the placebo group during phase 1 were switched to 0.05% atropine at the beginning of the second-year follow-up; children in the atropine groups were maintained on the same dosages as in phase 1.

    Outcomes

    Over the 2-year period, the mean spherical equivalent progressions were 0.55 D, 0.85 D and 1.12 D and the mean axial length changes were 0.39 mm, 0.50 mm, and 0.59 mm in the 0.05%, 0.025% and 0.01% atropine groups, respectively. No treatment-related side effects were noted.

    Limitations

    Since the study switched the placebo group to atropine 0.05% due to ethical considerations, there were no results comparing placebo versus atropine. Phase 3 and 4 LAMP studies are current being planned and should yield more useful results.

    Clinical significance

    The current LAMP study showed that the 0.05% atropine concentration is the best for myopia control over a 2-year period. Although low-dose atropine is definitely very effective for myopia progression, the exact dosing schedule is yet to be determined.