Abstract
Purpose
Atropine eye drops are a common and effective treatment for slowing myopia progression, but the site and mode of action of atropine in controlling myopia are unclear. We investigated the early retinal sites of action of atropine by examining its effects on the human full-field electroretinogram (ffERG).
Method
Baseline ffERGs were recorded in both eyes of 24 healthy subjects (mean ± SD: 21.0 ± 2.3 years; spherical equivalent refraction, range: + 1.63 to − 0.75 D) using 6 standard ISCEV protocols, 30 min after bilateral pupil dilation with 1% Tropicamide. Atropine (1 drop, 0.1%) was then instilled into the non-dominant eye. 24 h later, ffERGs were again recorded in both eyes. Ratios (post-atropine: pre-atropine) of dark-adapted (DA) and light-adapted (LA) ffERGs were compared between atropine-treated and control eyes using multivariate repeated measures general linear models.
Results
Atropine-treated eyes responded with 14% lower DA3.0 OP (oscillatory potential) amplitude (p = 0.003) and 4% delay in the DA10.0 a-wave peak time (p = 0.00099) compared with control eyes. Amplitudes and peak times were not different between atropine-treated and control eyes for DA0.01, LA3.0, and LA3.0 flicker ERGs. While atropine caused a small (1.26 mm2, p = 0.03) extra increase in pupil area in the treated eye, atropine-induced changes in ffERG responses bore no relationship with changes in pupil area (R2 = 2–5%, p > 0.05).
Conclusions
The observed changes in oscillatory potentials corroborate previous findings that atropine affects neural activity in the inner retina. However, observed changes to the a-wave suggest that atropine also affects activity in photoreceptors.
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Acknowledgements
The authors thank the New Zealand Association of Optometrists for a Higher Degree Research Write-up Scholarship to SK
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Safal Khanal’s contributions included Conceptualization, Methodology, Formal analysis, Visualisation, Writing – Original Draft. Sachi Rathod’s contributions included Investigation, Data Curation, Project Administration. John Phillips’ contributions included Conceptualization, Supervision, Resources, Writing – Review and Editing.
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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. The study was approved by the Human Participants Ethics Committee of the University of Auckland (ref: 017982).
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This study was presented in part at the 17th International Myopia Conference, Tokyo, Japan, September 2019. Author SK was the recipient of a University of Auckland PhD scholarship funded by CooperVision Inc. Author SNR was supported by a summer research scholarship awarded by the Faculty of Medical and Health Science, University of Auckland.
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Khanal, S., Rathod, S.N. & Phillips, J.R. The acute effect of atropine eye drops on the human full-field electroretinogram. Doc Ophthalmol 142, 315–328 (2021). https://doi.org/10.1007/s10633-020-09806-8
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DOI: https://doi.org/10.1007/s10633-020-09806-8