초등학교 근시 환아에서 저농도 아트로핀 점안이 근시 진행에 미치는 영향

Efficacy of Low-dose Atropine Eyedrops in Myopic Progression in Elementary School Children

목적: 초등학교 근시 환아에서 저농도 아트로핀 점안이 근시 진행에 미치는 효과를 연구하였다. 대상과 방법: 저농도 아트로핀 점안 전, 후 6개월간 의무기록을 후향적으로 분석하였다. 점안 방법은 저농도 아트로핀(atropine sulfate 0.125%) 점안 후 인공누액(sodium hyaluronate 0.1%)을 양안에 점안하는 방법으로 매일 1회 점안하였다. 대조군은 근시 환아들을대상으로 하였다. 굴절이상, 안축장길이, 동공 크기, 조절근점을 측정하였으며 6개월 동안 두통, 눈부심 등 증상을 조사하였다. 결과: 116명의 환자 중 아트로핀 점안군은 65명, 대조군은 51명이었다. 아트로핀 점안군의 연령은 10.2 ± 1.8세 (6-11세)였다. 처음방문 시 굴절이상은 -4.7 ± 2.1 D (-1.0 to -10.5), 안축장길이는 24.95 ± 1.02 mm (22.58-27.99)였고 6개월 후 굴절이상의 변화는-0.9 ± 1.1 D (-0.75 to -4.75), 안축장길이 변화는 0.47 ± 0.39 mm (0.01-1.6)였다. 저농도 아트로핀 점안 6개월 후 굴절력의 변화는-0.1 ± 0.2 D (0 to -0.25)였고 안축장길이 변화는 0.15 ± 0.23 mm (0-1.05)로 유의하게 감소하였다(p＜0.001). 동공 크기는 6.7 ± 0.6 mm (5.3-9.3)였고 조절근점은 6.1 ± 2.0 cm (3.1-11.0)였다. 근거리 작업 불편은 2명(3.1%)에서 관찰되었다. 결론: 저농도 아트로핀 점안은 초등학교 환아에서 근시 억제에 효과가 있을 것으로 생각된다.

Purpose: We analyzed the effects of low-dose atropine on myopic progression in elementary schoolchildren aged 6-11 years. Methods: Medical records were retrospectively reviewed before and after 6 months of low-dose atropine eyedrops. Myopia was defined as a spherical equivalent < -1 diopter. Low-dose atropine eyedrops (atropine sulfate 0.125% [w/v]) and artificial tear eyedrops (sodium hyaluronate 0.1% [w/v]) immediately afterwards were applied to both eyes daily, and all children regularly visited us for measurement of refractive power, axial length, pupil diameter, and near-point accommodation. symptoms (headache, light sensitivity, near-work disturbance, allergic reaction, dry eye, and poor night vision) were recorded. Results: A total of 116 patients were included. Atropine was prescribed for 65 patients, the remaining 51 patients constituted the control group. In the atropine group, the mean age was 10.2 ± 1.8 years and 23 patients (35.4%) were male. At the initial visit, the mean refractive power was -4.7 ± 2.1 diopters (D) (-1.0 to -10.5) and the mean axial length was 24.95 ± 1.02 mm (22.58-27.99). At the 6-month follow-up, the change of refractive power was -0.9 ± 1.1 D (-0.75 to -4.75) and the change of axial length was 0.47 ± 0.39 mm (0.01-1.6). However, 6 months after application of low-dose atropine eyedrops, the change of refractive power was -0.1 ± 0.2 D (0 to -0.25) and the change of mean axial length was 0.15 ± 0.23 mm (0-1.05). The mean pupil diameter was 6.7 ± 0.6 mm (5.3-9.3) and the near accommodation point was 6.1 ± 2.0 cm (3.1-11.0). Two patients (3.1%) complained of near-work disturbance but none stopped taking the eyedrops. Conclusions: Significant decreases in the changes of refractive power and axial length were evident in myopic elementary schoolchildren after low-dose atropine therapy. Low-dose atropine attenuates myopic progression without severe complications.