Eight-year findings from the Low-Concentration Atropine for Myopia Progression Study
Jason Yam, MD, of the Chinese University of Hong Kong, spoke at AAO 2025 about the LAMP1 study, which assessed the safe and optimal way to discontinue atropine treatment for myopia in children.
Jason Yam, MD:
Hi everyone. I am Jason Yam from the Chinese University of Hong Kong from Hong Kong, China. It’s my great honor today to be able to share some of our findings to all of you. I’m the principal investigator of the LAMP1 study. [The] LAMP1 study is the Low-Concentration Atropine for Myopia Progression Study. We are in the AAO. We are presenting our 8-year results.
The LAMP1 study is a randomized, placebo-controlled trial to start with. It is a trial to look into how…which concentration of the low-concentration atropine in myopia progression 0.05, 0.025, 0.01, and placebo. Now up to this stage, in this phase, it is a phase 5, we call it a phase 5 study, that is a look into the year 6 to year 8. What we are going to look into is we want to look into 2 questions. The first question is how can we discontinue the treatment appropriately? The second question is, what are the factors affecting the approach to discontinue the treatment?
What we do is in the 6th year we do a randomization for all the children who have been completed in the year 5 and are still on atropine treatment we randomize them into 2 groups. Roughly there is about 250 children. We randomize into 2 arms. One is what we call taper. The other arm is what we call stop. These 2 arms is to [determine] the 2 different approaches to discontinue the treatment. In the taper arm, what we do is over 3 years time, the first year is to stop the treatment in the taper group. In the first 6 months, we used 0.05% atropine. The other 6 months we use 0.025% atropine. We taper and then we stop the treatment and then observe for the year 7 and year 8 for 2 years.
Whereas in the stop group we use 0.05% atropine for the whole year, in the first 6 months, and then in the second 6 months and then we stop. Then we observe in the year 7 and year 8. This is a randomized, controlled trial to look into these children, how we stop the protocol.
The second analysis is to look into the factors affecting this. What’s the result? We found that in fact in the taper group, the response is better than the stop group. What does it mean? In terms of whether the treatment can be appropriately stopped, we defined over 2 years time whether the progression rebound back for more than 0.0 diopter. If it is less than 0.0 diopter over 2 years, and then we call it success. Then if it is more than 0.5 diopter after 2 years, we define it not success.
For the taper group, in fact, the success rate is 65% compared to the stop group, which is only about 40%. In terms of the anterior progression and anterior elongation, the taper group is better than the stop group. Then we also look into the factors affecting these approaches. Number 1 is the age, and number 2 is the baseline spherical equivalent. Meaning that number 1, if we are older, if the children are older, the more likely we can discontinue the treatment successfully. Number 2, if the children are less myopic, again, it’s more likely we can discontinue the treatment appropriately. We also find another very interesting finding, in fact the difference between the taper and in the stop group. One difference is also determined by the age. If a child is at younger age, they will benefit more from the taper approach. Whereas in a child at the older age, the difference between taper and stop is not as more as the child at a younger age.
In summary, in our study what we found is number 1, we conclude taper approach is better than stop approach in discontinuing low-concentration atropine. Number 2, yes, age and myopic baseline is also important in determining whether we can discontinue the treatment. Number 3, for younger children, they will benefit more from the taper approach than older children. This is some of our findings I would like to share. Thank you very much.
