The rising prevalence of myopia and the threat it poses to vision and eye health emphasize the importance of finding effective treatments to slow progression and axial elongation. Researchers in Taiwan conducted a prospective case series study to further evaluate the safety of cumulative atropine exposure and found that its effects do not correlate with dosage. They did not observe elevated IOP in myopic children following one year of atropine use.

The myopic participants, between the ages of three and 17, were divided into two groups: 121 children who received atropine of various concentrations and doses and 65 controls. The treatment group received doses of 50mg at a concentration of 1%, 25mg at 0.5%, 12.5mg at 0.25% or 5mg at 0.1%.

As expected, the study’s results showed significantly less myopic progression in the atropine-treated group than the untreated group at the one-year follow-up, whether measured by spherical power, cylinder power or spherical equivalent. They noted no significant difference between the atropine subgroups. Both study groups showed an increase in mean IOP at the last follow-up, but both low- and high-cumulative atropine dosages caused a smaller increase in IOP.

While their study revealed that topical atropine eye drops do not induce ocular hypertension and can effectively slow the progression of myopia, the researchers emphasized their focus on the effect of cumulative atropine dosage, which was affected by the concentration of the drug and the duration of therapy. “A high cumulative dose might not necessarily mean a high concentration of the drug was administered at each treatment, and this difference in our study design might cause conflicting results,” they concluded in their paper.

Yu TC, Wu TE, Wang YS, et al. A STROBE-compliant case-control study: effects of cumulative doses of topical atropine on intraocular pressure and myopia progression. Medicine (Baltimore). 2020;99(48):e22745.