Medicated eye drops may delay myopia in children
The goal of the research, according to the study, was to evaluate the efficacy of low-concentration atropine eyedrops at 0.05% and 0.01% concentration for delaying the onset of myopia. (Adobe Stock image)
Using nightly eye drops with 0.05 percent atropine could slow the progression of myopia in children, at least temporarily, according to a recent study.
The study,1 published recently in JAMA, focused on the use of drops with 0.05 percent atropine, a medication that relaxes the eye muscle responsible for focusing vision.
The prevalence of myopia has risen rapidly over the last few decades. About one-fourth of the global population currently has the condition. It is expected to affect half of people worldwide by 2050.
While low-dose atropine eye drops are currently being used to slow myopia progression in several countries in Asia, Jason Yam, PhD, and colleagues set out to determine if the medication could also the onset of myopia. Yam is an ophthalmologist with the Chinese University of Hong Kong.
In the randomly assigned clinical trial that included 474 children aged 4 to 9 years without myopia, nightly use of 0.05% atropine, 0.01% atropine, and placebo eyedrops resulted in a 2-year cumulative incidence of myopia of 28.4%, 45.9%, and 53.0%, respectively. The difference between 0.05% atropine and placebo was statistically significant.
The first recruited participant started treatment on July 11, 2017, and the last participant was enrolled on June 4, 2020; the date of the final follow-up session was June 4, 2022.
According to the study, while 0.05% atropine eyedrops resulted in a significantly lower incidence of myopia at 2 years compared with placebo, further research is needed to replicate the findings and to understand whether this represents a delay or prevention of myopia.
Researchers also pointed out that the early onset of myopia is associated with high myopia later in life, and myopia is irreversible once developed.
The goal of the research, according to the study, was to evaluate the efficacy of low-concentration atropine eyedrops at 0.05% and 0.01% concentration for delaying the onset of myopia.
Participants were assigned at random to the 0.05% atropine (n = 160), 0.01% atropine (n = 159), and placebo (n = 155) groups and had eyedrops applied once nightly in both eyes over 2 years.
According to researchers, the primary outcomes were the 2-year cumulative incidence rate of myopia (cycloplegic spherical equivalent of at least −0.50 D in either eye) and the percentage of participants with fast myopic shift (spherical equivalent myopic shift of at least 1.00 D).
Of the 474 randomized patients (mean age, 6.8 years; 50% female), 353 (74.5%) completed the trial. The 2-year cumulative incidence of myopia in the 0.05% atropine, 0.01% atropine, and placebo groups were 28.4% (33/116), 45.9% (56/122), and 53.0% (61/115), respectively, and the percentages of participants with fast myopic shift at 2 years were 25.0%, 45.1%, and 53.9%.
Compared with the placebo group, the 0.05% atropine group had significantly lower 2-year cumulative myopia incidence (difference, 24.6% [95% CI, 12.0%-36.4%]) and percentage of patients with fast myopic shift (difference, 28.9% [95% CI, 16.5%-40.5%]). Compared with the 0.01% atropine group, the 0.05% atropine group had significantly lower 2-year cumulative myopia incidence (difference, 17.5% [95% CI, 5.2%-29.2%]) and percentage of patients with fast myopic shift (difference, 20.1% [95% CI, 8.0%-31.6%]).
According to researchers, the 0.01% atropine and placebo groups were not significantly different in 2-year cumulative myopia incidence or percentage of patients with fast myopic shift. Photophobia was the most common adverse event and was reported by 12.9% of participants in the 0.05% atropine group, 18.9% in the 0.01% atropine group, and 12.2% in the placebo group in the second year.
Researchers also found that among children aged 4 to 9 years without myopia, nightly use of 0.05% atropine eyedrops compared with placebo resulted in a significantly lower incidence of myopia and lower percentage of participants with fast myopic shift at 2 years.
“There was no significant difference between 0.01% atropine and placebo,” the researchers concluded. “Further research is needed to replicate the findings, to understand whether this represents a delay or prevention of myopia, and to assess longer-term safety.”
1 Jason C. Yam, MPH. Klu Juan Zhang, PhD, Yuzhou Zhang, PhD; et.al. Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children: The LAMP2 Randomized Clinical Trial. JAMA. Published February 13, 2023. doi: 10.1001/jama.2002.24162
Respiratory Outbreak Over: Jasper Place – Thunder Bay District Health Unit
March 27, 2023 – The Thunder Bay District Health Unit (TBDHU) and The City of Thunder Bay – Jasper Place confirm that the respiratory outbreak at Jasper Place, located at 1200 Jasper Drive, has been declared over. All outbreak restrictions have been lifted.
TBDHU recommends the public refrain from visiting hospitals, long-term care facilities and other high risk settings when feeling unwell to avoid spreading infections to those most vulnerable and at higher risk of severe outcomes.
The Health Unit reminds the public that they can prevent getting and spreading infections by:
- Staying at home when sick. Wearing a well-fitted mask in indoor spaces, especially when around vulnerable people or when recovering from illness.
- Keeping up-to-date with influenza and COVID-19 vaccinations.
- Washing hands often, for at least 20 seconds with soap and warm water, or by using an alcohol-based hand sanitizer.
- Covering coughs/sneezes with the upper sleeve if no tissue is available.
- Being familiar with the Ontario screening tool, to self-assess and know what to do next.
For more information on current outbreaks, please visit the following link: https://www.tbdhu.com/outbreaks.
For more information – TBDHU Media: email@example.com
Diseases & Infections
COVID cold and flu assessment centre to close Friday
It’s the end of an era of the pandemic.
The COVID Cold and Flu Care Clinic at 400 Southgate Dr. is closing at the end of the week.
The location will take patients until the end of day Friday.
Guelph General Hospital said in a news release the closure is because of the steady few months of low volumes and stable COVID hospital admissions.
“The COVID, Cold, Flu Care Clinic played a significant role in meeting the needs of the community during the pandemic by providing community residents a much-needed alternative to the emergency department and primary care,” Guelph General Hospital president and CEO Marianne Walker said in a release.
“As care transitions back to community providers, I’d like to thank the over 100 team members from Guelph General Hospital, Guelph Family Health Team and other partner organizations for their valuable service during some very difficult times.”
The clinic opened in September 2020, after moving over from the Victoria Road Recreation Centre. The clinic also used to operate on Delhi Street.
The Southgate Drive location expanded last December to include treatment for cold and flu symptoms.
Anyone looking for COVID-19, cold and flu treatment are now asked to go to family doctors, walk-in clinics, pharmacies and clinics led by Guelph Family Health Team physicians and nurse practitioners.
Severe COVID cases should still go to the emergency department.
Wellington-Dufferin-Guelph Public Health said it will still offer COVID-19 and flu shots at its Chancellors Way building.
The hospital does caution that COVID-19 is still prevalent in the community, and to continue taking precautions if you’re not feeling well.
Whooping cough on the rise in southern Ontario
Several public health units in southwestern Ontario say they’ve seen a spike in cases of whooping cough and are urging residents to get vaccinated against the respiratory illness that can be particularly severe in young children.
Southwestern Public Health – which serves Oxford County, Elgin County and St. Thomas, Ont. – said it recorded 82 cases of whooping cough from January 2022 to the end of this February.
“This was 40 per cent of the provincial total from that time period,” Dr. Ninh Tran, medical officer of health for Southwestern Public Health, said in an interview.
“It’s a significant increase … that is certainly striking.”
Previous years have seen annual caseloads in the single digits, Tran said.
Whooping cough, or pertussis, can see a person’s cough intensify to the point where a “whooping” sound is heard when they try to catch their breath, Tran said.
Lower rates of immunization against whooping cough could be a factor in the rise in cases, he said.
“In our region, we have relatively lower rates of immunization compared to others,” Tran said.
“We’ve had a few cases that were hospitalized. That’s why we just really need folks to get up-to-date on their immunization.”
Huron Perth Public Health, which serves Stratford, Wingham, Listowel and Clinton, said it has confirmed at least 21 cases of whooping cough so far this year. In 2022, there were only three cases.
“The illness can be serious for infants younger than 12 months of age who are not vaccinated, or who have not received all doses of the pertussis vaccine,” Dr. Miriam Klassen, the medical officer of health for Huron Perth, wrote in a statement.
“Young children have the highest risk for severe complications, such as hospitalization and death, if they get sick.”
Klassen said the COVID-19 pandemic might have put residents of southern Ontario behind on routine immunizations, and urged residents to catch up on their vaccines.
The Windsor-Essex County Health Unit said there had been “a recent dramatic rise” in whooping cough cases in its region. It said last week that it counted 18 cases since November 2022.
“Cases have predominately been clustered in the Leamington and Kingsville communities, and exclusively in children who are unvaccinated or partially vaccinated,” it wrote in a statement, urging residents to get vaccinated.
The health unit noted that the cough brought on by pertussis can be so severe that it can cause vomiting. If left untreated in infants, young children and the elderly, it “can lead to complications such as pneumonia, dehydration, brain damage, hospitalization and death.”
Wellington-Dufferin-Guelph Public Health said it recorded 12 cases over the fall and winter, which is “higher than normal for the region.”
“Many individuals may be behind in their vaccinations because they were unable to get them due to COVID-19,” it wrote in a statement. “Now is the time to get fully vaccinated as we engage in more community activities.”
This report by The Canadian Press was first published March 27, 2023.
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