Future clinical trials may benefit from more selective recruitment of participants, based on criteria identified in this study. Photo: Getty Images.

A recent analysis of the Myopia Outcome Study of Atropine in Children (MOSAIC) offers new insight into influential factors behind slow and fast progression—age and time spent reading, according to MOSAIC results, presented recently at ARVO in New Orleans. These factors may help to strengthen future study enrollment, the researchers say.

The study included children aged six to 16 randomized 2:1 to either 0.01% atropine or placebo drops nightly for two years. Spherical equivalent refraction (SER) was measured using cycloplegic autorefraction, and axial length (AL) was measured using partial coherence interferometry. Children’s eyes in the top and bottom 25% of SER and AL change were considered fast and slow progressors, respectively.

Of the 250 enrolled participants (mean age 11.8 years, 62% female), 204 (83%) completed the 24-month study. SER changes among fast and slow progressors were ≤-0.875D and ≥-0.125D, respectively. Among fast and slow AL progressors, changes were ≥0.53mm and ≤0.15mm, respectively. The researchers reported that younger age and more time spent reading at baseline were significantly associated with higher risk of fast progression on multivariable analysis. Older age was significantly associated with a higher likelihood of slow AL progression.

“Age remains the most significant factor for determining risk of fast or slow SER or AL progression,” the researchers explained in their abstract. “More time spent reading was also associated with higher risk of fast SER and fast AL progression, which may enhance the selective recruitment of participants to clinical trials.”

Original abstract content © Association for Research in Vision and Ophthalmology 2023.

Biba M, Lingham G, Kobia-Acquah E, et al. Risk factors for fast and slow myopia progression in a randomized controlled trial of 0.01% atropine eye drops. ARVO 2023 annual meeting.