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Myopia ProgressionPhase 2LAMPNCT06265454

Low Dose Atropine Eye Drops in Myopic Egyptian Children

A Phase 2 study testing low dose atropine eye drops in people with Myopia Progression and Axial Length, Eye, run by Ain Shams University at 1 site in Egypt.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Previous Studies reported that low concentration atropine eye drops may be effective in increasing the choroidal blood flow and thickness and this slows myopia progression. purpose of the study is to compare changes in axial length, anterior chamber depth, choroidal thickness, central corneal thickness and anterior… Read more about this study

Who is it for?
Ages 6 to 12 years
What is being tested?
low dose atropine eye drops
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
75 participants
Where
1 siteEgypt
Study dates
1 Sep 2024to 30 Mar 2026
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Age ranges from 6 to 12.
  • Spherical equivalent ≥ -1.0 D.

Who cannot join

  • Astigmatism ≥ 3.0 D.
  • History of allergy to atropine or positive skin allergy test.
  • Ocular pathology otherwise myopia.
  • Recent ocular surgery.
  • Chronic systemic disease.
  • Use of rigid contact lenses or soft contact lenses for 1 week before participating in the study

Trial locations and contacts

1 site in 1 country.

Aya MA Abd El wahab, masters contact

1009192526 ext. +20

ayamah711@gmail.com

Egypt1 site
  • Ain shams university

    Cairo, Abbasia, 11517

    Aya MA Abd El wahab, Masters, 1009192526 ext. +20, ayamah711@gmail.com

    Marwa M Abd al Karim, MD

Other trials in Egypt

About this study

Official title: Effect of Low Concentration Atropine Eye Drops on Choroidal Thickness, Central Corneal Thickness, Anterior Scleral Thickness and Axial Length in Myopic Children

Previous Studies reported that low concentration atropine eye drops may be effective in increasing the choroidal blood flow and thickness and this slows myopia progression.

purpose of the study is to compare changes in axial length, anterior chamber depth, choroidal thickness, central corneal thickness and anterior scleral thickness among myopic children receiving atropine 0.05% or 0.01% and placebo.

Read the detailed description

Myopia is the most common refractive error, and its prevalence rate is increasing worldwide, as per WHO, it is projected to increase from 22% in 2000 to 52% by 2050. It is more prevalent in developed, industrial areas and affects individuals of all ages (Singh et al., 2022). Myopia, especially the degenerative type, is associated with sight-threatening complications, including presenile cataract, glaucoma, retinal detachment, choroidal neovascularization, myopic macular degeneration, scleral and choroidal thinning (Sanchez-Cano et al., 2014 and Gupta et al., 2015) which makes myopia a major public health concern and finding an effective treatment to prevent myopia progression is critical (Wakazono et al., 2016).

Atropine is a nonselective muscarinic antagonist used for myopia control in previous studies. However, its actual mechanism of action is not well known (Yam et al., 2019).

But different mechanisms were described, first mechanism, that atropine may induce release of dopamine causing thickening of choroid (Nickla et al., 2010) Second mechanism,blockage of choroidal smooth muscle contraction through its anti-muscarinic action. Third one, increasing capillary permeability. Fourth, potentiating the synthesis and release of intraocular nitric oxide (Yam et al.,2022) also it stimulates retinal expression of the transcription factor ZENK which was considered an eye growth-inhibiting signal (Torii et al., 2017). All these mechanisms cause thickening of the choroid and increased choroidal blood flow which has been found to play a role in the regulation of eye growth and refractive error development through inhibition of the penetration of various retinal-derived growth factors that act as mechanical barriers and slow scleral growth (Nickla et al., 2015 \& Guggenheim et al., 2011). Also, choroid can secrete growth factors that prevent scleral hypoxia (Wu et al., 2018).

According to the Low-concentration Atropine for Myopia Progression (LAMP) study, different atropine eye drops concentrations 0.05%, 0.025%, and 0.01% controlled myopia progression but the most effective concentration on spherical equivalent and axial length progression was 0.05% (Yam et al., 2019).

Zhang et al. reported in 2016 that administration of 1% atropine gel increased the choroidal thickness in young Chinese children with inhibition of eye growth.

Also, jiang et al. in 2021 mentioned that after one week of administration of 1% atropine significant changes in spherical equivalent, axial length and choroidal thickness and after cessation of the medication for 7 weeks those returned to baseline levels.

In 2022, Zhou et al. reported also increased sub foveal choroidal thickness and in all quadrants in myopes in contrast to increased thickness in nasal quadrant only in hyperopes and non-significant change in emmetropes.

A recent study in 2023 found a dose dependent ocular biometrics changes, including axial length and anterior chamber depth, during low-dose atropine treatment in children with myopia (Hvid-Hansen et al., 2023).

In Li et al. study in 2021 they mentioned that younger children required higher atropine concentrations to show better responses.

In 2023, Zhou et al. reported thinner anterior sclera in myopes compared to emmetropes and a negative correlation between anterior scleral thickness (AST)and axial length and recommended usage of AST as a tool for monitoring of myopia progression.

Optical Coherence Tomography (OCT) is a non-invasive imaging modality, it was first reported in 1991 as a diagnostic technology that provides a cross-sectional image of the retina and choroid. It creates a cross-sectional map of the retina based on low-coherence interferometry (Aumann et al., 2019).

There are two types of OCT, time domain OCT and spectral domain OCT but the most widely used now is spectral domain OCT as it has scan rate between 20,000 and 40,000 per second which improves resolution and reduces the likelihood of missing lesions (Xie et al., 2021).

Being tested
low dose atropine eye drops, Placebo
Keywords
myopia, low dose, atropine eye drops, mypoic children, myopia progression, LAMP
Medical subject headings
Myopia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • low dose atropine eye dropsDrug

    Atropine is a nonselective muscarinic antagonist used for myopia control in previous studies.

  • PlaceboDrug

    placebo

Study groups in NCT06265454
Study groupRoleWhat they receive
myopic children atropine 0.05%Active comparatorthey will receive topical atropine 0.05% for 12 weeks and all investigations will be done before administration of atropine (baseline assessment), then after 1 month, 2 months, 3 months.
Receives: Drug: low dose atropine eye drops
myopic children atropine 0.01%Active comparatorthey will receive topical atropine 0.01% for 12 weeks and all investigations will be done before administration of atropine (baseline assessment), then after 1 month, 2 months, 3 months.
Receives: Drug: low dose atropine eye drops
myopic children placeboPlacebo comparatorthey will receive placebo for 12 weeks and all investigations will be done before administration of placebo (baseline assessment), then after 1 month, 2 months, 3 months.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. change in the average Choroidal Thickness over follow up period.

    Follow up of choroidal thickness during treatment period

    Measured: from enrollment till end of eye drops trial over 3 months and after stopping the drops for 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Feb 2024
  2. Study start1 Sep 2024 (estimated)
  3. Primary completion30 Dec 2025 (estimated)
  4. Study completion30 Mar 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06265454
Sponsor's protocol ID
LDAED IN MC
Acronym
LAMP
Status last verified
Feb 2024
First submitted
11 Feb 2024
Last updated
20 Feb 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zhang Z, Zhou Y, Xie Z, Chen T, Gu Y, Lu S, Wu Z. The effect of topical atropine on the choroidal thickness of healthy children. Sci Rep. 2016 Oct 7;6:34936. doi: 10.1038/srep34936.

    PubMed 27713535
  • Zhou J, He H, Yang Q, Wang JY, You ZP, Liu LL. Comparison of anterior sclera thickness in emmetropes and myopes. BMC Ophthalmol. 2023 Feb 14;23(1):67. doi: 10.1186/s12886-023-02775-x.

    PubMed 36782174
  • Ye L, Shi Y, Yin Y, Li S, He J, Zhu J, Xu X. Effects of Atropine Treatment on Choroidal Thickness in Myopic Children. Invest Ophthalmol Vis Sci. 2020 Dec 1;61(14):15. doi: 10.1167/iovs.61.14.15.

    PubMed 33320168
  • Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, Ko ST, Young AL, Tham CC, Chen LJ, Pang CP. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019 Jan;126(1):113-124. doi: 10.1016/j.ophtha.2018.05.029. Epub 2018 Jul 6.

    PubMed 30514630
  • Xie R, Qiu B, Chhablani J, Zhang X. Evaluation of Choroidal Thickness Using Optical Coherent Tomography: A Review. Front Med (Lausanne). 2021 Dec 3;8:783519. doi: 10.3389/fmed.2021.783519. eCollection 2021.

    PubMed 34926529
  • Wang Y, Zhu X, Xuan Y, Wang M, Zhou X, Qu X. Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children. Ophthalmol Ther. 2022 Apr;11(2):833-856. doi: 10.1007/s40123-022-00476-0. Epub 2022 Feb 20.

    PubMed 35184254
  • Wakazono T, Yamashiro K, Miyake M, Nakanishi H, Oishi A, Ooto S, Tsujikawa A, Yoshimura N. Association between Eye Shape and Myopic Traction Maculopathy in High Myopia. Ophthalmology. 2016 Apr;123(4):919-21. doi: 10.1016/j.ophtha.2015.10.031. Epub 2015 Dec 11. No abstract available.

    PubMed 26686963
  • Torii H, Ohnuma K, Kurihara T, Tsubota K, Negishi K. Violet Light Transmission is Related to Myopia Progression in Adult High Myopia. Sci Rep. 2017 Nov 6;7(1):14523. doi: 10.1038/s41598-017-09388-7.

    PubMed 29109514
  • Singh H, Singh H, Latief U, Tung GK, Shahtaghi NR, Sahajpal NS, Kaur I, Jain SK. Myopia, its prevalence, current therapeutic strategy and recent developments: A Review. Indian J Ophthalmol. 2022 Aug;70(8):2788-2799. doi: 10.4103/ijo.IJO_2415_21.

    PubMed 35918918
  • Sanchez-Cano A, Orduna E, Segura F, Lopez C, Cuenca N, Abecia E, Pinilla I. Choroidal thickness and volume in healthy young white adults and the relationships between them and axial length, ammetropy and sex. Am J Ophthalmol. 2014 Sep;158(3):574-83.e1. doi: 10.1016/j.ajo.2014.05.035. Epub 2014 Jun 5.

    PubMed 24907431
  • Nickla DL, Totonelly K, Dhillon B. Dopaminergic agonists that result in ocular growth inhibition also elicit transient increases in choroidal thickness in chicks. Exp Eye Res. 2010 Nov;91(5):715-20. doi: 10.1016/j.exer.2010.08.021. Epub 2010 Aug 27.

    PubMed 20801115
  • Nickla DL, Totonelly K. Choroidal thickness predicts ocular growth in normal chicks but not in eyes with experimentally altered growth. Clin Exp Optom. 2015 Nov;98(6):564-70. doi: 10.1111/cxo.12317.

    PubMed 26769180
  • Jiang Y, Zhang Z, Wu Z, Sun S, Fu Y, Ke B. Change and Recovery of Choroid Thickness after Short-term Application of 1% Atropine Gel and Its Influencing Factors in 6-7-year-old Children. Curr Eye Res. 2021 Aug;46(8):1171-1177. doi: 10.1080/02713683.2020.1863431. Epub 2021 Jan 4.

    PubMed 33390025
  • Hvid-Hansen A, Jacobsen N, Hjortdal J, Moller F, Ozenne B, Kessel L. Low-Dose Atropine Induces Changes in Ocular Biometrics in Myopic Children: Exploring Temporal Changes by Linear Mixed Models and Contribution to Treatment Effect by Mediation Analyses. J Clin Med. 2023 Feb 17;12(4):1605. doi: 10.3390/jcm12041605.

    PubMed 36836139
  • Gupta P, Jing T, Marziliano P, Cheung CY, Baskaran M, Lamoureux EL, Wong TY, Cheung CM, Cheng CY. Distribution and determinants of choroidal thickness and volume using automated segmentation software in a population-based study. Am J Ophthalmol. 2015 Feb;159(2):293-301.e3. doi: 10.1016/j.ajo.2014.10.034. Epub 2014 Nov 5.

    PubMed 25447120

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing low dose atropine eye drops in people with Myopia Progression and Axial Length, Eye, run by Ain Shams University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 20 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Aya MA Abd El wahab, masters (1009192526 ext. +20, ayamah711@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

change in the average Choroidal Thickness over follow up period. (time frame: from enrollment till end of eye drops trial over 3 months and after stopping the drops for 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06265454, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2024.

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