A study included in ARVO’s online meeting reported that 0.05% atropine drops remain the optimal concentration, with continued treatment over three years achieving a sustained effect. But what happens when kids complete the regimen?

The team followed 210 children aged four to 12 years with myopia of at least -1.0D who were randomized to receive atropine 0.05%, 0.025% or 0.01% once daily in both eyes. At the beginning of the third year, patients in each group were split, with half continuing treatment and the other ceasing treatment. Cycloplegic refraction, axial length, accommodation amplitude, pupil diameter and best-corrected visual acuity were measured at four-month intervals.

Over the three-year period, the investigators found that the concentration-dependent response remained. Over three years with continued 0.05%, 0.025% and 0.01% atropine treatment, they noted that the mean spherical equivalent (SE) progression was 0.94D, 1.23D and 1.54D, respectively, and that the mean axial length changes increased by 0.59mm, 0.71mm and 0.83mm, respectively.

During the third year, the researchers saw that the group continuing to receive 0.05% atropine achieved slower SE progression and axial elongation than the group that ceased treatment (-0.65D vs. -0.25D and 0.31mm vs. 0.20mm, respectively). In the cessation treatment group, they observed a similar rebound phenomenon across each concentration of atropine. They added that pupil size and accommodation returned to baseline in all concentrations after cessation of treatment.

Yam J, Li FF, Zhang X, et al. Low concentration atropine for myopia progression (LAMP) Phase 3: efficacy of 0.05%, 0.025%, and 0.01% atropine eye drops over three years and the rebound phenomenon after cessation of treatment. ARVO 2020. Abstract 1133.