Optic Nerve Head Changes over 15 Years-From the Atropine Treatment Long-Term Assessment Study.

Purpose: To investigate optic nerve head (ONH) changes over 15 years from childhood to adulthood. Design: A longitudinal study. Participants: The Atropine Treatment Long-Term Assessment Study (ATLAS) included 148 myopic participants from the Atropine for the Treatment of Myopia 2 (ATOM2) trial. Methods: During ATOM2, all participants were treated with daily atropine eye drops in concentrations of 0.01%, 0.1%, or 0.5%. The ATLAS recall visit was conducted in 2021-2022. At 3 study visits-ATOM2 baseline, last ATOM2 (5-year), and ATLAS recall (15-year)-participants underwent cycloplegic autorefractometry, biometry, and fundus photography. At recall, OCT centered on the optic disc was additionally performed. Fundus photographs were morphometrically examined for ONH ovality, torsion, parapapillary atrophy (PPA), disc-fovea distance, position of the central retinal vascular trunk (CRVT), angle kappa, and vertical distance between the arterial arcade. OCT images were analyzed for Bruch membrane opening distance, gamma zone, and Bruch membrane overhang. Main Outcome Measures: Optic nerve head changes from childhood to young adulthood and associated factors. Results: Optic nerve head characteristics were similar across atropine treatment groups. Myopic refractive error increased from -4.54 ± 1.64 diopters (D) at baseline to -6.35 ± 2.02 D at 5 years to -6.88 ± 2.4 D at 15 years ( Conclusions: This long-term study suggests that myopic subjects showed increased PPA and nasal CRVT shift from childhood into young adulthood. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.