Little effect of 0.01% atropine eye drops as used in myopia prevention on the pattern electroretinogram
Daily administration of 0.01% atropine eye drops is a promising approach for myopia control. The mechanism of action is believed to involve the dopaminergic system of the retina, triggering an increased release of dopamine. Previous studies in psychiatric condition such as major depression suggest that pattern electroretinogram (PERG) amplitudes are modulated by changes in retinal dopamine. It is thus plausible that atropine eye drops could have an effect on PERG amplitudes. The present study was designed to test this, assessing the difference in amplitude between contrast levels and the ratio of amplitudes between check sizes as primary endpoints.
We included 14 participants with no more than ± 2 diopters of ametropia and visual acuity of at least 1.0. One eye was chosen randomly in each participant for atropine application (14 days, one drop of 0.01% atropine solution once daily before bedtime). We recorded two sets of steady-state PERG recordings: one with different contrasts (25% and 98%) and one with different check sizes (0.8° and 17°). Near-point distance, near visual acuity, and pupil diameter were measured additionally.
The recordings to different contrasts did not show atropine-related changes of PERG amplitude. A small increase by 6% of the amplitude difference between contrast levels with atropine application was not significant (p = 0.08). Raw amplitudes in the check size condition increased with atropine by 17% (p < 0.01) and 10% (p < 0.03) for small and large checks, respectively, without a significant concomitant effect on the amplitude ratio. Pupil size was significantly affected (median increase 0.5 mm, p < 0.002). However, neither of the experimental conditions was associated with a significant correlation between pupil size and PERG effects.
The effects on PERG primary endpoints after the 14-day period of atropine administration were small, especially compared to effect sizes in major depression, and statistically insignificant. Effects on raw amplitude were inconsistent. The present results suggest that retinal processing as reflected by PERG does not sizably change following a treatment regimen with atropine that is typical for myopia control.
KeywordsPattern electroretinogram Atropine Myopia Dopamine
We are grateful to numerous members of our department with an interest in the topic who stimulated and encouraged the work presented here. Most of these individuals also volunteered as participants in this self-experimentation study. In order to ensure the protection of their personal data, we do not list them by name.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of human rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Statement on the welfare of animals
This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 10.Iuvone PM, Tigges M, Stone RA, Lambert S, Laties AM (1991) Effects of apomorphine, a dopamine receptor agonist, on ocular refraction and axial elongation in a primate model of myopia. Investig Ophthalmol Vis Sci 32:1674–1677Google Scholar
- 15.Domenici L, Trimarchi C, Piccolino M, Fiorentini A, Maffei L (1985) Dopaminergic drugs improve human visual contrast sensitivity. Hum Neurobiol 4:195–197Google Scholar
- 20.Schwitzer T, Lavoie J, Giersch A, Schwan R, Laprevote V (2015) The emerging field of retinal electrophysiological measurements in psychiatric research: a review of the findings and the perspectives in major depressive disorder. J Psychiatr Res 70:113–120. https://doi.org/10.1016/j.jpsychires.2015.09.003 CrossRefGoogle Scholar
- 25.Dawson WW, Trick GL, Litzkow CA (1979) Improved electrode for electroretinography. Investig Ophthalmol Vis Sci 18:988–991Google Scholar
- 31.Pineles SL, Kraker RT, VanderVeen DK, Hutchinson AK, Galvin JA, Wilson LB, Lambert SR (2017) Atropine for the prevention of myopia progression in children: a report by the American Academy of Ophthalmology. Ophthalmology 124:1857–1866. https://doi.org/10.1016/j.ophtha.2017.05.032 CrossRefGoogle Scholar