National Study Aims to Combat Childhood Myopia with Atropine

The University of Houston is co-leading a pioneering national study to determine whether low-concentration atropine eyedrops can delay the onset of nearsightedness, or myopia, in children aged 6 to 11 years. This significant research initiative, known as the Delaying the Onset of Nearsightedness Until Treatment (DONUT) Study, aims to establish new standards in vision care. The study combines efforts from the University of Houston and The Ohio State University and has secured funding of $25 million from the National Eye Institute, part of the National Institutes of Health.

David Berntsen, co-principal investigator and a professor of optometry at the University of Houston, emphasized the importance of this research. He noted that as myopia progresses, individuals face an increased risk of serious eye complications, including myopic degeneration, retinal detachment, and glaucoma. The primary objective is to minimize the degree of myopia in children, thereby potentially reducing future vision-related complications.

Exploring the Efficacy of Atropine

Previous research from both the United States and Asia indicates that atropine can effectively slow the progression of myopia once it has developed. Notably, a study conducted in Asia suggested that atropine eyedrops could delay the onset of nearsightedness. However, this current study is the first to investigate the drug’s effectiveness in a preventative capacity within the United States.

Researchers will focus on children identified as high-risk for developing myopia, particularly those whose farsightedness has diminished to critical levels by the time they reach third grade. Studies have shown that nearly 90% of these children are likely to develop nearsightedness by the eighth grade. Participants will be recruited from across the country, with the clinical trial taking place at the University of Houston, Ohio State, and 12 additional research centers nationwide.

The trial will involve enrolling over 600 children, who will be randomly assigned to receive nightly doses of either 0.05% low-concentration atropine or a placebo for a duration of two years. The onset of nearsightedness in these children will be compared with those receiving the placebo, and participants in the placebo group who develop myopia during the study will subsequently receive the atropine treatment. All children diagnosed with myopia will also receive an annual voucher for corrective lenses.

Tackling the Growing Challenge of Myopia

Myopia affects at least one-third of adults in the United States, and its prevalence has been increasing. Researchers attribute this trend partly to children’s reduced outdoor activity compared to previous generations. Historically, myopia was regarded as a mere inconvenience, but advancements in vision research have shifted towards a deeper understanding of its underlying mechanisms and the potential to mitigate long-term risks associated with the condition.

Berntsen, along with co-leaders Jeffrey Walline from Ohio State’s College of Optometry and Lisa Jordan, a research professor and director at the Data Coordination and Analysis Center at Ohio State, have previously demonstrated that multifocal contact lenses can effectively slow the progression of myopia. Their findings from a 2020 clinical trial revealed that these lenses significantly reduced myopia progression in children as young as seven.

The economic implications of myopia are substantial, with the annual cost of corrective measures in the United States estimated to range from $4 billion to $7 billion. Furthermore, high myopia can limit options for corrective surgeries and other vision correction methods. As the number of myopic individuals is expected to reach 50% globally by 2050, proactive measures to delay the onset of myopia could have a profound impact on public health.

“This new study will investigate whether we can delay the onset of myopia in children,” Berntsen stated, highlighting the urgency of the situation. The researchers anticipate that the use of atropine drops could decrease the incidence of myopia from 20% in the placebo group to 10% in the treatment group, and that it will slow pre-myopic eye growth by 30% over the study period.

As the trial progresses, the insights gained could shape future strategies in preventing myopia and improving eye health for generations to come.