【Medical Line Fax】
Recently, Shenyang Xingqi Eye Hospital stated that its Internet hospital has suspended the sale of 0.01% atropine sulfate eye drops (also known as low-concentration atropine eye drops).
The eye drops once swept the Internet.
Many parents believe that the eye drops have a relieving effect on juvenile myopia, calling it "myopia magic medicine".
So, what is atropine?
Are low-concentration atropine eye drops really a "myopia medicine"?
What signal did this online sale stop event send out?
In this regard, the reporter of Science and Technology Daily interviewed relevant experts.
There are clear indications not suitable for all patients with myopia
Atropine eye drops is a competitive muscarinic receptor (M receptor) antagonist, the main component of which is atropine.
According to the concentration of atropine, atropine eye drops can be divided into 0.01%, 0.02%, 0.1% and other different types.
Generally speaking, considering factors such as the effectiveness of atropine, side effects, and the probability of rebound after drug withdrawal, most of the current clinical use of low-concentration (ie, 0.01%) atropine eye drops.
Existing experimental data show that atropine eye drops may act on multiple targets and delay the progression of myopia through multiple pathways.
"It has two main functions: one is to control the growth of the eye axis. The growth of the eye axis will accelerate the development of myopia, so controlling the excessive growth of the eye axis is an important part of preventing and controlling myopia. Atropine eye drops can alleviate the Scleral hypoxia and choroidal blood perfusion pressure increase, thereby inhibiting the growth of the eye axis. The second is to relax the eye muscles. Atropine eye drops can block the innervation of cholinergic nerves to the ciliary muscle and pupillary sphincter, and effectively relieve the eye. Muscle spasm and fatigue, relax the eyes, and then achieve the effect of controlling the development of myopia." An ophthalmologist in a tertiary hospital in Beijing, who did not want to be named, told reporters.
In recent years, studies have indeed found that low-concentration atropine eye drops can delay the development of myopia in children.
However, atropine eye drops have specific clinical indications and are not suitable for all patients with myopia.
The above-mentioned doctors said that in terms of age, the people who use the drug should be myopic patients from 4 years old to adolescence, but children under 6 years old need to be more closely monitored and followed up if they use this drug; from the point of view of degree, atropine eye drops The solution is suitable for people whose spherical equivalent power increases by more than 50 degrees every year; in addition, people with rapidly progressive risk factors such as high myopia hereditary history can also use the drug under the guidance of a doctor.
The above-mentioned doctors emphasized that patients should comprehensively consider their effectiveness, side effects, indications and contraindications when choosing drugs.
Cannot reverse myopia with certain side effects
In the eyes of some parents, low-concentration atropine eye drops can not only delay the development of myopia, but even cure myopia, so is this true?
In this regard, the above-mentioned doctor explained: "Once true myopia occurs, it is difficult to reverse. We can only control the degree of myopia not to increase too fast. Low-concentration atropine eye drops is a way to control the growth of myopia, but it cannot cure myopia. "
At a press conference held by the National Health and Medical Commission in May 2020, Wei Wenbin, vice president of Beijing Tongren Hospital and director of the Department of Ophthalmology, said that low-concentration atropine eye drops are not "magic medicine", and some children will experience photophobia, Near-sightedness is unclear, drug allergies, etc., and some children cannot effectively control the development of myopia even if they use low-concentration atropine eye drops.
Therefore, experts do not recommend self-use of low-concentration atropine eye drops.
The above-mentioned doctor, who did not want to be named, said that if you plan to use this eye drop, you must first go to a professional medical institution to let the ophthalmologist understand the condition and give professional advice before using it.
Parents should fully understand the efficacy and risks of such drugs, and cannot give their children low-concentration atropine eye drops without the guidance of a doctor.
Some industry experts said that prescribing low-concentration atropine eye drops through the "Internet hospital channel + in-hospital preparation qualification" method may have the risk of lax prescription review, expanding the scope of use, and increasing the difficulty of follow-up and observation.
Referring to the suspension of online sales of low-concentration atropine eye drops, the above-mentioned doctor who did not want to be named believes that this is good news.
On the one hand, this is conducive to regulating the use of atropine eye drops.
At present, the atropine eye drops approved in China are all approved in the form of in-hospital preparations. Online sales are suspended, and atropine eye drops can only be purchased with prescriptions. The diagnosis and treatment process of myopia in adolescents also meets the requirements of the whole course of disease management.
On the other hand, the fact that this incident has received attention means that people are paying more and more attention to the problem of young people's myopia, which is conducive to further promoting the prevention and control of young people's myopia.
Wei Wenbin said that not only relying on eye drops to prevent and control young people's myopia, reducing close-range eye use, paying attention to eye posture, and increasing outdoor exercise are the most important ways to prevent and control myopia.