The use of atropine to curb myopia remains under investigation, particular the right dosing for the best balance between treatment efficacy and side effects. Adding to the latest research, a new study in JAMA Ophthalmology reports 0.01% atropine eye drops can slow myopia progression and axial elongation in Chinese children. Still, the researchers noted their study’s limitations since only about 70% of enrolled subjects returned for follow-up.
The randomized, placebo-controlled, double-masked study enrolled 220 children between the ages of six and 12 who had myopia of -1.00D to -6.00D in both eyes. The investigation was conducted at Beijing Tongren Hospital in China, and the children’s cycloplegic refraction and axial length were measured at baseline and at six and 12 months. Patients were randomly assigned in a 1:1 ratio to 0.01% atropine or placebo, administered once nightly to both eyes for one year. The mean baseline refractive error and axial length were -2.58D and 24.59mm.
Follow up at one year included 76 children who took atropine (69%) and 83 children in the placebo group (75%). In the atropine group, mean myopia progression was -0.49D, while progression in the placebo group was -0.76D—a mean difference of 0.26D. The researchers calculated a relative reduction of 34.2% in myopia progression.
Looking at axial elongation, the mean in the atropine group was 0.32mm vs. 0.41mm in the placebo group (mean difference of 0.09 mm), for a reduction of 22%.
In children who took atropine, 51% progressed to at least 0.50D and 13.2% progressed to 1.00D, compared with 69.9% and 34.9% in the placebo group, respectively. The study reported no serious adverse events in children who were administered atropine.
The investigation’s results warrant future studies to determine longer-term results and potential effects on slowing sight-threatening pathologic changes later in life, the researchers noted.
Wei S, Li SM, An W, et al. Safety and efficacy of low-dose atropine eyedrops for the treatment of myopia progression in Chinese children a randomized clinical trial. JAMA Ophthalol. October 1, 2020. [Epub ahead of print].