Differential impact of combined therapy and monotherapy with 0.05% atropine eyedrops and dual focus contact lenses on choroid.

Purpose: To investigate changes in the choroid and axial length (AL) during one month of combined therapy and monotherapy with 0.05% atropine and dual-focus soft contact lens (DFCL), and the impact after discontinuation.

Methods: Myopic adults randomly received three interventions: 0.05 % atropine, DFCL, and 0.05 % atropine combined with DFCL. Choroidal thickness (ChT), choroidal vascularity index (CVI) and AL were measured at baseline, 3, 7, 14, and 30 days after intervention, and 1, 2, 7, 14, and 30 days after discontinuation.

Results: The ChT thickened and AL decreased after one month of combination therapy (24.19 ± 4.13 μm, P = 0.001; -40.35 ± 9.55 μm, P = 0.024) or 0.05 % atropine (20.52 ± 4.35 μm, P = 0.008; -8.07 ± 7.22 μm, P = 0.002) but not DFCL (8.95 ± 4.25 μm, P > 0.999; -14.89 ± 7.28 μm, P > 0.999). The increase in ChT and decrease in AL persisted for 2 days after 0.05 % atropine was discontinued, persisted for 7 days and 14 days after combination therapy was discontinued. There was no significant change in the CVI after one month use or withdrawal of any intervention (P > 0.999). After one month of combination therapy, significant correlations were observed between the baseline CVI and changes in ChT (r = 0.485, P = 0.035) or AL (r = -0.589, P = 0.008).

Conclusion: Monotherapy involving 0.05% atropine or the combination of 0.05% atropine with DFCL significantly affected ChT thickening and AL shortening. These changes were maintained for a longer duration post combination intervention. The baseline CVI was associated with changes in ChT and AL during combination treatment.