Abstract：
OBJECTIVE: To assess the effect of weekly 1% atropine use on children\'s myopia progression and whether the effect is sustainable.
METHODS: Medical records of myopic children aged 3-15 years receiving weekly 1% atropine for more than 1 year were retrospectively reviewed. Axial length (AL) and spherical equivalent refraction (SER) at every visit were collected. The changes in AL or SER over time were analysed using generalised estimating equation. The related factors of myopic progression were performed by multiple linear regression. The performance of short-term AL change to predict atropine-poor responders (AL change >0.2 mm/year) was assessed using receiver operating characteristic analysis.
RESULTS: A total of 694 participants with a mean age of 8.83 years were included. The participants with follow-up time reached 1, 2, 3 and 4 years were 256 (36.9%), 250 (36.0%), 143 (20.6%) and 45 (6.5%) separately. The cumulative change in AL was 0.05 mm, 0.24 mm, 0.47 mm, 0.56 mm separately for 1-year, 2-year, 3-year and 4- year treatment. Approximate 0.20 mm elongation per year was observed since the second-year of the treatment. Older age and lower initial myopic refraction were independently associated with less myopic progression. A decrease in AL of more than 0.04 mm during the initial 2 months could serve as an indicator for identifying fast progressors (AL change >0.2 mm/year) over a 2-year period, with sensitivity and specificity rates of 0.78 and 0.73, respectively.
CONCLUSIONS: Weekly 1% atropine may be a potentially effective treatment with longer lasting effects for children with myopia control especially in those with older age and lower myopia.
METHODS: Medical records of myopic children aged 3-15 years receiving weekly 1% atropine for more than 1 year were retrospectively reviewed. Axial length (AL) and spherical equivalent refraction (SER) at every visit were collected. The changes in AL or SER over time were analysed using generalised estimating equation. The related factors of myopic progression were performed by multiple linear regression. The performance of short-term AL change to predict atropine-poor responders (AL change >0.2 mm/year) was assessed using receiver operating characteristic analysis.
RESULTS: A total of 694 participants with a mean age of 8.83 years were included. The participants with follow-up time reached 1, 2, 3 and 4 years were 256 (36.9%), 250 (36.0%), 143 (20.6%) and 45 (6.5%) separately. The cumulative change in AL was 0.05 mm, 0.24 mm, 0.47 mm, 0.56 mm separately for 1-year, 2-year, 3-year and 4- year treatment. Approximate 0.20 mm elongation per year was observed since the second-year of the treatment. Older age and lower initial myopic refraction were independently associated with less myopic progression. A decrease in AL of more than 0.04 mm during the initial 2 months could serve as an indicator for identifying fast progressors (AL change >0.2 mm/year) over a 2-year period, with sensitivity and specificity rates of 0.78 and 0.73, respectively.
CONCLUSIONS: Weekly 1% atropine may be a potentially effective treatment with longer lasting effects for children with myopia control especially in those with older age and lower myopia.
摘要：
目的：评估每周服用1%阿托品对儿童近视进展的影响，以及这种影响是否可持续。
方法：对每周服用1%阿托品超过1年的3-15岁近视儿童的病历进行回顾性分析。收集每次就诊时的轴向长度（AL）和球面等效屈光度（SER）。使用广义估计方程分析了AL或SER随时间的变化。采用多元线性回归分析近视进展的相关因素。使用接受者工作特征分析评估短期AL变化预测阿托品不良反应者（AL变化>0.2mm/年）的性能。
结果：共纳入694名参与者，平均年龄为8.83岁。随访时间达到1年、2年、3年和4年的参与者为256例(36.9%),250（36.0%），143（20.6%）和45（6.5%）。AL的累积变化为0.05mm，0.24mm,0.47mm,1年分别为0.56毫米，2年,3年和4年治疗。自治疗的第二年起,观察到每年大约0.20mm的伸长。年龄较大和较低的初始近视屈光度与较少的近视进展独立相关。在最初的2个月中，AL的减少超过0.04毫米可以作为在2年内识别快速进展者（AL变化>0.2毫米/年）的指标，敏感性和特异性分别为0.78和0.73。
结论：每周1％阿托品可能是一种潜在的有效治疗方法，对近视控制儿童尤其是年龄较大和近视较低的儿童具有更持久的效果。
方法：对每周服用1%阿托品超过1年的3-15岁近视儿童的病历进行回顾性分析。收集每次就诊时的轴向长度（AL）和球面等效屈光度（SER）。使用广义估计方程分析了AL或SER随时间的变化。采用多元线性回归分析近视进展的相关因素。使用接受者工作特征分析评估短期AL变化预测阿托品不良反应者（AL变化>0.2mm/年）的性能。
结果：共纳入694名参与者，平均年龄为8.83岁。随访时间达到1年、2年、3年和4年的参与者为256例(36.9%),250（36.0%），143（20.6%）和45（6.5%）。AL的累积变化为0.05mm，0.24mm,0.47mm,1年分别为0.56毫米，2年,3年和4年治疗。自治疗的第二年起,观察到每年大约0.20mm的伸长。年龄较大和较低的初始近视屈光度与较少的近视进展独立相关。在最初的2个月中，AL的减少超过0.04毫米可以作为在2年内识别快速进展者（AL变化>0.2毫米/年）的指标，敏感性和特异性分别为0.78和0.73。
结论：每周1％阿托品可能是一种潜在的有效治疗方法，对近视控制儿童尤其是年龄较大和近视较低的儿童具有更持久的效果。
