Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis
Background/Purpose: Orthokeratology (Ortho-K), atropine eye drops and combined atropine with Ortho-K are proven to be effective ways to prevent myopic progression in many studies, but there is scarce evidence regarding the comparative efficacy of different dosages of atropine,Ortho-K, and combined a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664622002108 |
| _version_ | 1811217175983161344 |
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| author | Hou-Ren Tsai Jen-Hung Wang Huei-Kai Huang Tai-Li Chen Po-Wei Chen Cheng-Jen Chiu |
| author_facet | Hou-Ren Tsai Jen-Hung Wang Huei-Kai Huang Tai-Li Chen Po-Wei Chen Cheng-Jen Chiu |
| author_sort | Hou-Ren Tsai |
| collection | DOAJ |
| description | Background/Purpose: Orthokeratology (Ortho-K), atropine eye drops and combined atropine with Ortho-K are proven to be effective ways to prevent myopic progression in many studies, but there is scarce evidence regarding the comparative efficacy of different dosages of atropine,Ortho-K, and combined atropine with Ortho-K for childhood myopia. Methods: We performed a network meta-analysis (NMA) to assess the relative efficacy of the aforementioned interventions for myopic progression; moreover, we calculated the surface under cumulative ranking area (SUCRA) to determine the relative ranking of treatments. Results: We identified 19 randomized controlled trials (3435 patients). NMA revealed that 0.01%–1% atropine, Ortho-K, and 0.01% atropine combined with Ortho-K inhibited axial elongation (AL) over one year. For refractive change, SUCRA analysis revealed that the hierarchy was high-dose (0.5%–1%), moderate-dose (0.1%–0.25%), and low-dose (0.01%–0.05%) atropine. Regarding AL, SUCRA analysis revealed the following hierarchy: Ortho-K combined with 0.01% atropine, high-dose atropine, moderate-dose atropine, Ortho-K, and low-dose atropine. Conclusion: In conclusion, we found that atropine (0.01%–1%), Ortho-K, and 0.01% atropine combined with Ortho-K could significantly slow down myopia progression. The atropine efficacy followed a dose-related pattern; moreover, Ortho-K and low-dose atropine showed similar efficacy. There was a synergistic effect of using 0.01% atropine combined with Ortho-K, and it showed comparable efficacy to that of high-dose atropine. |
| first_indexed | 2024-04-12T06:49:33Z |
| format | Article |
| id | doaj.art-d0a0f0132fb84e93a8f3ee8228f88687 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-12T06:49:33Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-d0a0f0132fb84e93a8f3ee8228f886872022-12-22T03:43:24ZengElsevierJournal of the Formosan Medical Association0929-66462022-12-011211224902500Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysisHou-Ren Tsai0Jen-Hung Wang1Huei-Kai Huang2Tai-Li Chen3Po-Wei Chen4Cheng-Jen Chiu5Department of Medical Education, Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, Taiwan; School of Medicine, Tzu Chi University, Hualien, TaiwanDepartment of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, 970, TaiwanSchool of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Family Medicine and Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, TaiwanDepartment of Medical Education, Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, Taiwan; School of Medicine, Tzu Chi University, Hualien, TaiwanDepartment of Medical Education, Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, Taiwan; School of Medicine, Tzu Chi University, Hualien, TaiwanDepartment of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan; Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 970, Taiwan; Corresponding author. Department of Ophthalmology and Visual Science, Tzu Chi University, Department of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung-Yang Road, Hualien, 97002, Taiwan. Fax: +(03)8560977.Background/Purpose: Orthokeratology (Ortho-K), atropine eye drops and combined atropine with Ortho-K are proven to be effective ways to prevent myopic progression in many studies, but there is scarce evidence regarding the comparative efficacy of different dosages of atropine,Ortho-K, and combined atropine with Ortho-K for childhood myopia. Methods: We performed a network meta-analysis (NMA) to assess the relative efficacy of the aforementioned interventions for myopic progression; moreover, we calculated the surface under cumulative ranking area (SUCRA) to determine the relative ranking of treatments. Results: We identified 19 randomized controlled trials (3435 patients). NMA revealed that 0.01%–1% atropine, Ortho-K, and 0.01% atropine combined with Ortho-K inhibited axial elongation (AL) over one year. For refractive change, SUCRA analysis revealed that the hierarchy was high-dose (0.5%–1%), moderate-dose (0.1%–0.25%), and low-dose (0.01%–0.05%) atropine. Regarding AL, SUCRA analysis revealed the following hierarchy: Ortho-K combined with 0.01% atropine, high-dose atropine, moderate-dose atropine, Ortho-K, and low-dose atropine. Conclusion: In conclusion, we found that atropine (0.01%–1%), Ortho-K, and 0.01% atropine combined with Ortho-K could significantly slow down myopia progression. The atropine efficacy followed a dose-related pattern; moreover, Ortho-K and low-dose atropine showed similar efficacy. There was a synergistic effect of using 0.01% atropine combined with Ortho-K, and it showed comparable efficacy to that of high-dose atropine.http://www.sciencedirect.com/science/article/pii/S0929664622002108MyopiaOrthokeratologyAtropineCombined atropine with orthokeratology |
| spellingShingle | Hou-Ren Tsai Jen-Hung Wang Huei-Kai Huang Tai-Li Chen Po-Wei Chen Cheng-Jen Chiu Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis Journal of the Formosan Medical Association Myopia Orthokeratology Atropine Combined atropine with orthokeratology |
| title | Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis |
| title_full | Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis |
| title_fullStr | Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis |
| title_full_unstemmed | Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis |
| title_short | Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis |
| title_sort | efficacy of atropine orthokeratology and combined atropine with orthokeratology for childhood myopia a systematic review and network meta analysis |
| topic | Myopia Orthokeratology Atropine Combined atropine with orthokeratology |
| url | http://www.sciencedirect.com/science/article/pii/S0929664622002108 |
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