Effect of Low-Concentration Atropine Eye Drops on Parapapillary Gamma Zone Development and Enlargement over 3 Years: The LAMP Study
Year: 2026
Type: article
Abstract: Purpose To evaluate the longitudinal changes in the parapapillary gamma zone in children receiving 0.05%, 0.025%, 0.01% atropine eyedrops and placebo/switchover over 3 years based on the Low-Concentration Atropine for Myopia Progression (LAMP1) study. Design Secondary analysis from a randomized controlled trial. Participants 280 children underwent spectral domain optical coherence tomography (SD-OCT) at baseline, which involved 24 equally spaced radial OCT B-scans of the optic nerve head, taken at one-year intervals. Methods Children in the LAMP1 study were randomized to receive 0.05%, 0.025%, 0.01% atropine, or placebo eyedrops. In the second year, placebo participants switched to 0.05% atropine. At the beginning of the third year, each group was re-randomized to continued treatment or cessation (washout). The Bruch's membrane opening (BMO) was identified in 48 meridians in each eye. Gamma zone was defined as the parapapillary region without Bruch's membrane. Main Outcome Measures Differences between treatment groups in gamma zone area changes from baseline to the 3-year follow-up visits. Results Out of 238 children included at baseline, the study included 192 (80.7%) children completing the follow-up of 3 years. The cumulative mean gamma zone area changes differed significantly between the initial 0.05%, 0.025%, and 0.01% atropine subgroups (0.09±0.09mm 2 , 0.19±0.12mm 2 , and 0.22±0.17mm 2 ; P for trend<0.001) over 3 years. In multivariable analysis, gamma zone area enlargement was associated with 0.05% atropine (β=-0.07, P =0.005), female sex (β=0.05, P =0.006), larger baseline gamma zone area (β=0.23, P <0.001), and larger axial elongation (β=0.14, P <0.001). Conclusion Low-concentration atropine reduced parapapillary gamma zone enlargement in a concentration-dependent manner over a 3-year treatment period. Continued 0.05% atropine treatment showed efficacy in controlling gamma zone development.
Source: Ophthalmology Science
Institutions: Chinese University of Hong Kong, Chinese University of Hong Kong, Shenzhen, University of Hong Kong, Prince of Wales Hospital, Hong Kong Eye Hospital, Hong Kong Children's Hospital, Singapore National Eye Center, New York Eye and Ear Infirmary, L V Prasad Eye Institute, Hôpital Rothschild, Singapore Eye Research Institute, Fondation de Rothschild, Beijing Tsinghua Chang Gung Hospital, Icahn School of Medicine at Mount Sinai, Tsinghua University, Institute of Science Tokyo
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
Awards: Low-Concentration Atropine for Myopia Progression (LAMP) Phase 5 Study: 7-year follow up to evaluate the treatment cessation strategy: Stop versus Taper, Deep multimodal learning based management of myopia in children, G2688879004, Ocular imaging biomarkers for attention deficit hyperactivity disorder (ADHD), Novel optical coherence tomography imaging biomarkers for high myopia in children and adults to assess visual damage severity, G4232435952, G6563764987, G834158847
OpenAlex ID: W7125428720