A-eyedrops on Ocular Alignment and Binocular Vision
Status:
Not yet recruiting
Trial end date:
2024-06-30
Target enrollment:
Participant gender:
Summary
Atropine is a non-selective muscarinic acetylcholine (M) receptor antagonist that paralyzes
the ciliary muscle, dilates the pupil, and reduces the power of accommodation. Current
studies have confirmed the effect of low concentrations of atropine drops in slowing the
progression of myopia. In the ATOM2 study, there was a rapid and dose-dependent decrease in
accommodation after atropine drops: after 2 weeks of use, accommodation decreased from
baseline 16.2D to 11.3D (4.9D) in the 0.01% atropine drops group, from baseline 16.7D to 3.8D
(12.9D) in the 0.1% atropine group, and from baseline 15.8 D to 2.2 D (13.6 D) in the 0.5%
atropine group; one year after withdrawal, there was some recovery of the accommodation in
all the three groups, but it was still lower than the baseline values for each group, with a
mean decrease of 2.56 D.Similar results were found in the LAMP study by Janson C. Yam, 0.05%
atropine drops reduced the accommodation by approximately 2D on average after 1 year of
treatment.
In general, if accommodation decreases by 2D or more compared to normal values, accommodation
insufficiency is considered. There is a linkage between accommodation and convergence called
AC/A which is closely related to exotropia. It was reported that the amount of accommodation
required to maintain binocular fusion in patients with intermittent exotropia was greater
than that of normal controls. In addition, pupil size and visual acuity are also factors that
affect accommodation. In summary, the reduced accommodation amplitude, pupil dilation, and
blurred near vision caused by atropine drops would affect the progression of intermittent
exotropia and the ocular alignment after the surgery. In most cases, the reduced
accommodation and convergence might induce exotropia, but in some patients, they may use more
accommodative stimuli to compensate the insufficiency of accommodation, and there may be an
increase in convergence or even esotropia.
Taken together, due to the effect of atropine drops on pupil size, near visual acuity, and
accommodation amplitude, the investigators hypothesize that atropine drops are likely to
affect binocular vision and ocular alignment in patients with exotropia and exophoria.
Phase:
N/A
Details
Lead Sponsor:
Eye & ENT Hospital of Fudan University
Collaborators:
Aier Eye Affiliated Hospital of Wuhan University Children's Hospital of Fudan University Renmin Hospital of Wuhan University Shandong Provincial Hospital Shanxi Eye Hospital The Second Affiliated Hospital of Harbin Medical University Tianjin Eye Hospital Xinhua Hospital, Shanghai Jiao Tong University School of Medicine