# Myopic Progression Associated with COVID-19 Pandemic in Korean Children with Myopia Using 0.01% Atropine Eyedrops

## TL;DR

The study found that the rate of myopia progression in Korean children using 0.01% atropine eye drops increased during the pandemic, mainly in terms of refraction, not axial length.

## Contribution

The study specifically examines the impact of the pandemic on myopia progression in children using 0.01% atropine, a less common treatment.

## Key findings

- Myopia progression in refraction increased significantly during the pandemic compared to before.
- Axial length elongation did not show a significant change during the pandemic.
- Outdoor time decreased significantly, and this correlated with increased myopic progression.

## Abstract

Background: To evaluate the effect of the COVID-19 pandemic on myopic progression defined in terms of refractive change and axial length elongation in Korean children with myopia using 0.01% atropine eye drops. Methods: A retrospective review was performed on the medical records of 73 children aged 4 to 15 years with a baseline myopia of −0.50 diopters (D) or more who had used 0.01% atropine eye drops for more than 12 months before the onset of the COVID-19 pandemic in South Korea. The rate of myopic progression was compared between two periods: the pre- and post-pandemic eras, the latter of which was defined by the initiation of remote schooling in March 2020. At each visit, cycloplegic autorefraction and axial length were measured using a Zeiss IOL Master. Patients answered a questionnaire regarding their time spent on near work (computer, smartphone, reading, homework, after-school workbooks, drawing, etc.) and outdoors. Results: During the pandemic, in terms of refraction, myopia progressed at an average rate of −0.45 D/y, which was significantly faster than before the pandemic of −0.22D/y (p = 0.037). In contrast, axial length elongation was 0.22 mm/y and 0.19 mm/y before and after the pandemic, respectively, which was not significantly different (p = 0.546). Time spent on using computers, smartphones, and other near work significantly increased, while outdoor time had significantly decreased after the pandemic (paired t-test, all p < 0.001). The change in annual refractive myopic progression rate during the pandemic compared to the pre-pandemic period did not significantly correlate with changes in computer time, smartphone time, or other near work time (p = 0.134, 0.210, 0.863, respectively). However, the change in outdoor time showed a negative correlation with the change in annual myopic progression rate (r = −0.239, p = 0.041). Conclusions: Among Korean children aged 4 to 15 years receiving 0.01% atropine, the rate of myopic progression increased significantly in terms of refraction during the COVID-19 pandemic compared with the pre-pandemic period, whereas axial length progression did not change significantly.