Atropine has long been the myopia treatment of choice for many clinicans. However, the jury is still out on the optimal concentration and its efficacy. To investigate, the Low-Concentration Atropine for Myopia Progression (LAMP) study followed a total of 438 children ages four to 12 years with myopia through low-dose atropine treatments for a year.

The kids were randomly assigned to receive 0.05%, 0.025% or 0.01% atropine drops or placebo once nightly to both eyes for one year. The researchers collected cycloplegic refraction, axial length (AL), accommodation amplitude, pupil diameter and best-corrected visual acuity at baseline and two weeks, as well as four, eight and 12 months.

They found that, after a year, the mean change in spherical equivalent (SE) was −0.27 ±0.61D for the 0.05% atropine group, −0.46 ±0.45D for the 0.025% group, −0.59 ±0.61D in the 0.01% group and −0.81 ±0.53 D for the placebo group. AL increased by a mean of 0.20 ±0.25mm, 0.29 ±0.20mm, 0.36 ±0.29mm and 0.41 ±0.22mm for the 0.05%, 0.025% and 0.01% atropine groups, and placebo groups, respectively.

In addition, visual acuity and vision-related quality of life were not affected in each group.

“The 0.05%, 0.025%, and 0.01% atropine eye drops reduced myopia progression along a concentration-dependent response,” the study says. “All concentrations were well tolerated without an adverse effect on vision-related quality of life. Of the three concentrations used, 0.05% atropine was most effective in controlling SE progression and AL elongation over a period of one year.”

Yam JC, Jiang Y, Tang SM, et al. Low-concentration atropine for myopia progression (LAMP) study. Ophthalmology. July 06, 2018. [Epub ahead of print].