Comparison between Atropine Medication and Orthokeratology in Suppressing Myopia Progression in Children: a systematic review
Main Article Content
Background: The progression of myopia in children is mainly caused by near-work activities and diminishing time outdoors. These increase the risk of high myopia, resulting in retinal detachment or macular degeneration. There are several alternative interventions to slow myopia progression, such as Orthokeratology (Ortho-K) and Atropine Eyedrop. Objectives: Systematically compile current evidence from relevant peer-reviewed publications to assess children’s myopia progression efficacy between Atropine Eyedrop and Orthokeratology. Method: A literature search was conducted on Cochrane®, Pubmed®, and ProQuest® then selected based on inclusion (randomized controlled trial, cohort, myopic children under 18 years old, cycloplegic refraction, publication year between 2010 - 2022) and exclusion (conference abstracts, case reports, duplicate publications) criteria. Primary outcomes are mean changes of axial elongation and spherical equivalent refraction in diopters. The secondary outcome is the mean changes in the sub-foveal choroidal thickness. Furthermore, critical appraisal will be done on selected articles. Results: Two prospective RCTs (187 subjects) revealed: axial elongation and spherical equivalent refraction significantly reduced in both treatment groups. However, axial length reduction was better in the Atropine Eyedrop compared to the Ortho-K group (0.20?±?0.03 mm vs. 0.28?±?0.03 mm). Another study also revealed that AL increased in Atropine compared to the Ortho-K group (0.24 ± 0.06 mm vs. 0.32 ± 0.07 mm). Moreover, spherical equivalent refraction reduction was better in Atropine compared to the Ortho-K group (?0.30 ± 0.07 D vs. ?0.41 ± 0.08 D). Nevertheless, sub-foveal choroidal thickness was greater in Ortho-K compared to the Atropine group (19.33?±?2.63 ?m vs. 8.09?±?1.47 ?m). Conclusion: Atropine Eyedrop is potentially a better option in controlling myopia progression in children than Orthokeratology with minimal changes in sub-foveal choroidal thickness.
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