LAMP Study: Younger Children Need Stronger Atropine Dose

Low-concentration atropine has demonstrated good efficacy in childhood myopia control. However, a recent study shows that younger children require a slightly higher concentration of atropine to achieve myopia control success than their older counterparts.

The Low-Concentration Atropine for Myopia Progression (LAMP) study examined the effect of age and other factors on the use of atropine treatment to combat myopia progression in children. The research found a correlation between age and atropine treatment success.

A secondary analysis was conducted on children who had completed 2 years of the LAMP study and involved 350 children between the ages of 4 and 12 who had been assigned either 0.05%, 0.025%, or 0.01% atropine, or a placebo once nightly. 

During the second year, children who had been assigned to the placebo group were switched to the 0.05% atropine group. LAMP participants with previous experience in myopia control treatments, ocular or systemic disease, or a history of atropine allergies were excluded from the study.

Researchers evaluated several factors, including age at treatment, gender, time outdoors, hours of near work, treatment compliance, and baseline refraction. Predictive factors such as a change in spherical equivalent (SE) and axial length (AL) were analyzed.

The results revealed that all concentrations of atropine were tolerated among all age groups and that younger age was the only factor associated with SE progression and AL elongation in all groups, with poorer response correlating with younger age. 

However, response to the 0.05% atropine treatment seemed to improve each year from age 4 years to 12 years (P <.05). Meanwhile, it was noted that 6-year-olds treated with 0.05% atropine showed SE and AL similar results to their 8-year-old counterparts who were treated with 0.025% atropine and their 10-year-old counterparts who were treated with 0.01% atropine.

Limitations of this study include variables such as time spent reading and outdoors were collected with validated questionnaires, which can be affected by recall bias. It was also limited by switching the placebo group to treatment in the second year, which prevented further comparisons with the placebo group. 

“Younger age is associated with poor treatment outcomes for low-concentration atropine at levels of 0.05%, 0.025%, and 0.01% for myopia control,” the study concludes. 

Reference

Li FF, Zhang Y, Zhang X, et al. Age effect on treatment responses to 0.05%, 0.025%, and 0.01% atropine: Low-Concentration Atropine for Myopia Progression (LAMP) study. Published online January 7, 2021. Ophthalmology. doi:10.1016/j.ophtha.2020.12.036