ORCID
- Daniel Ian Flitcroft: 0000-0002-7004-6026
- James Loughman: 0000-0003-3130-8991
Abstract
Purpose: To investigate 2-year changes in macular choroidal thickness (ChT) in children receiving 0.01% atropine eyedrops and its relationship with spherical equivalent refraction (SER) progression and axial length (AL) elongation. Methods: A total of 250 myopic children aged 6–16 years (167%–0.01% atropine, 83-placebo) were enrolled in the MOSAIC (ISRCTN36732601) clinical trial. Participants with complete 2-year ChT (Topcon Triton Swept-Source OCT), SER, and AL data were included in this study. Changes in macular ChT at 2 years and associations with changes in SER and AL elongation were analysed using linear mixed models. Results: A total of 187 children (126%–0.01% atropine, 61-placebo) were included in the analysis. Choroidal thickness over 2 years was stable in the 0.01% atropine compared with placebo group, which exhibited consistent thinning in subfoveal (mean ± SE: 0.49 ± 2.22 μm vs. −9.46 ± 2.69 μm; p = 0.034), parafoveal (1.40 ± 1.73 μm vs. −8.11 ± 2.08 μm; p = 0.002), and perifoveal (0.80 ± 1.25 vs. −6.17 ± 1.69; p = 0.002) macular subfields. Choroidal thickening was observed in participants with slower axial eye growth and myopia progression, regardless of their treatment group. Mediation analysis indicated that atropine 0.01% had a significant effect on ChT, with 68.3% of the effect being direct and 31.7% mediated through axial length changes. For SER, the direct effect on ChT was 80%, with the remaining 20% mediated by SER changes. Conclusions: Myopic participants treated with 0.01% atropine exhibited stable ChT over 2 years, whereas the placebo group showed consistent thinning. The effect of atropine 0.01% on ChT was only partially explained by axial length and SER changes, indicating a direct effect of atropine treatment on the choroid.
Keywords
atropine, children, choroidal thickness, myopia, randomised controlled trial
DOI Link
Publication Date
2025-01-01
Publication Title
Acta Ophthalmologica
Volume
103
Issue
8
ISSN
1755-375X
First Page
984
Last Page
997
Deposit Date
2026-05-06
Funding
Health Research Board and Fighting Blindness, Ireland (MRCG 2016–13). Topcon Europe Medical B.V. The sponsors or funding organisations had no role in the design or conduct of this research.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Additional Links
Recommended Citation
Kobia-Acquah, Emmanuel; Lingham, Gareth; Flitcroft, Daniel Ian; and Loughman, James, "Two-year changes of macular choroidal thickness in response to 0.01% atropine eye drops: Results from the myopia outcome study of atropine in children (MOSAIC) clinical trial" (2025). Research Outputs: 2025-Present. 4.
https://arrow.tudublin.ie/ceyerro/4