臨床眼科78巻11号

2024年10月発行

増刊号 6年前の常識は現在の非常識！—AI時代へ向かう今日の眼科医へ

Ⅲ．近視

低濃度アトロピン治療

著者： 稗田牧¹

所属機関： ¹京都府立医科大学眼科学教室

ページ範囲：P.59 - P.62

文献概要

ここが変わった！

以前の常識

・学童の近視は眼鏡を処方したら治癒と考えてよい．

・アトロピン点眼は小児の調節麻痺下屈折検査に使用する．

現在の常識

・近視の進行予防が失明を防ぐ．

・低濃度アトロピン点眼は近視進行予防のエビデンスがある．

・未承認薬剤なので副作用に注意し，医師の裁量で使用する．

参考文献

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2）Lawrenson JG, Shah R, Huntjens B, et al：Interventions for myopia control in children：a living systematic review and network meta-analysis. Cochrane Database Syst Rev 2：CD014758, 2023

3）Araki S, Miki A, Goto K, et al：Changes in choroidal thickness and structure induced by 1％ atropine instillation in children with hyperopic anisometropic amblyopia. J Pediatr Ophthalmol Strabismus 60：39-45, 2023

4）Wang Y, Liu F, Zhu X, et al：Effects on radius of curvature and refractive power of the cornea and crystalline lens by atropine 0.01％ eye drops. Acta Ophthalmol 102：e69-e77, 2024

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8）Repka MX, Weise KK, Chandler DL, et al：Low-dose 0.01％ atropine eye drops vs placebo for myopia control：a randomized clinical trial. JAMA Ophthalmol 141：756-765, 2023

9）Hieda O, Hiraoka T, Fujikado T, et al：Assessment of myopic rebound effect after discontinuation of treatment with 0.01％ atropine eye drops in Japanese school-age children. Jpn J Ophthalmol 67：602-611, 2023

10）Chia A, Ngo C, Choudry N, et al：Atropine ophthalmic solution to reduce myopia progression in pediatric subjects：the randomized, double-blind multicenter phase Ⅱ APPLE study. Asia Pac J Ophthalmol（Phila） 12：370-376, 2023

11）Liang X, Wei S, Li SM, et al：Effect of atropine 0.01％ eye drops on the difference in refraction and axial length between right and left eyes. Ophthalmic Res 66：496-505, 2023

12）Yam JC, Zhang XJ, Zhang Y, et al：Effect of low-concentration atropine eyedrops vs placebo on myopia incidence in children：the LAMP2 randomized clinical trial. JAMA 329：472-481, 2023

13）Zhang XJ, Zhang Y, Yip BHK, et al：Five-year clinical trial of low-concentration atropine for myopia progression（LAMP）study：phase 4 report. Ophthalmology. doi：10.1016/j.ophtha.2024.03.013, 2024

14）Li Y, Yip M, Ning Y, et al：Topical atropine for childhood myopia control：the Atropine Treatment Long-Term Assessment Study. JAMA Ophthalmol 142：15-23, 2024

15）Wasserman BN, Massenzio E, Lee K, et al：Systolic hypertension as side effect of topical low dose atropine drops. Am J Ophthalmol Case Rep 33：102004, 2024