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In a paper titled "Combined 0.01% atropine with orthokeratology in childhood myopia control (AOK) study: A 2-year randomized clinical trial".
The team of authors in Hong Kong found that Low-Dose Atropine (0.01%) combined with OrthoKeratology over a two year period does slow the rate of elongation of the eye (which is how Myopia increases).
The largest effect of the combination occurred in the first 6 months, but was still evident over the whole two-year period.
The children treated with the AOK combined approach showed only 0.17mm axial growth over two years, compared to 0.34mm in the OrthoK-only group.
This represents 50% slower growth.
The benefits were enjoyed by children aged 6 to 11 years, with between 1 to 4 Dioptres of Myopia.
This study was also the first to measure potential mechanisms as to how pupil size and choroidal thickness may also contribute to the increased myopia.
Due to the action of the low-dose Atropine eye drops the children's pupil size was increased by around 0.5mm, but only 13% of children noted photophobia (sensitivity to light).
The low-dose Atropine eye drops did not affect their Amplitude of Accommodation so their reading vision was not blurred by the treatment.
Choroidal thickness increased in the AOK group increased significantly. This may be a potential mechanism to explain the additive efficacy, although an increase in ocular higher-order aberrations due to enlarged pupils is another possible mechanism.
More research is needed to see if variations will give even better control across the whole 24 month treatment period.
Citation: Qi Tan, Contact Lens and Anterior Eye, https://doi.org/10.1016/j.clae.2022.101723
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