A recent study suggests that 0.02% atropine eye drops could be more impactful on myopia progression than 0.01% atropine, while both concentrations may have similar effects on pupil diameter and accommodative amplitude after 12 months of treatment.

A cohort study assessed 400 myopic children divided into three groups: 138 were administered 0.02% atropine, 142 were administered 0.01% atropine and 120 served as controls. The team measured spherical equivalent refractive error, axial length, pupil diameter and accommodative amplitude at baseline and four, eight and 12 months after treatment.

After 12 months, the researchers observed refractive error changes of -0.38±0.35D, -0.47±0.45D and -0.70±0.60D in the 0.02% atropine, 0.01% atropine and control groups, respectively. They also observed axial length changes of 0.30±0.21mm, 0.37±0.22mm and 0.46±0.35mm, respectively. They noted that the differences in the change in axial length and spherical equivalent refractive error between the three groups were significant.

Between baseline and the 12-month visit, the investigators found that accommodative amplitudes significantly decreased and pupil diameters significantly increased in the two atropine groups, adding that there was no statistical difference in the change in accommodative amplitude and pupil diameter between the groups. The accommodative amplitude and pupil diameter in the control group remained stable. 

Fu A, Stapleton F, Wei L, et al. Effect of low-dose atropine on myopia progression, pupil diameter and accommodative amplitude: low-dose atropine and myopia progression. Br J Ophthalmol. February 21, 2020. [Epub ahead of print].