Myopia Progression Study Comparing Low-Dose (0.01%) Atropine Eye Drops with a Control Group

Purpose: To evaluate myopia progression in children treated with 0.01% atropine eye drops compared with controls. Methods: Two longitudinal cohorts of myopic children (atropine and control) were observed in different time periods. All children had an increase in myopia of greater than -0.50 diopters (D) or axial length (AL) growth of >0.20 mm in the previous year. Patients were examined at baseline and every 6 months for 18 months. The primary outcomes were the annual progression rate of spherical equivalent refractive error (SER) and AL. Response to treatment was categorized as insufficient, moderate, or good. Progression according to age was also evaluated. Statistical significance was defined as P < 0.05. Results: The study included 243 myopic children [127 (44.7%) female; mean age, 10.19 ± 2.29 years]. The atropine group comprised 158 (65%) children. At 18 months, the mean (95% confidence interval) change in SER was -0.85 D (-1.00, -0.69) in the control group and -0.73 D (-0.85, -0.61) in atropine (p = 0.295). The mean increase in AL was 0.41 mm (0.32, 0.50) in the control group and 0.33 mm (0.28, 0.39) in the atropine (p = 0.160). Children aged <9 years had the lowest percentage of success [3/21 (27.8%)] in the atropine group and the highest percentage of failure (63.2%) (p = 0.03). Conclusion: Atropine drops at 0.01% did not slow myopia progression. Increasing the concentration or combining with optical treatments may be necessary, particularly for children aged <9 years, who showed the greatest progression but also had the highest potential for myopia control.