Myopia progression can be decreased by low-dose atropine drops

The researchers reported that the mean changes in the spherical equivalent refraction and axial length were significantly lower in the atropine group compared with the placebo group. (Image credit: Adobe Stock/Evgenii)

In a recent myopia management trial, atropine 0.01% eye drops were found to decrease myopia progression over the course of 1 year in children.¹

A randomized trial, led by Isha Sharma, MD, and colleagues from the Department of Ophthalmology, University College of Medical Science & Guru Teg Bahadur Hospital, Delhi, evaluated the efficacy of low-dose atropine to halt myopia progression.

The study compared the mean changes in the spherical equivalent and axial length to a control group and evaluated the drug’s effect on the near vision, pupillary size, and keratometry and pachymetry values at 1 year.

Both eyes of 100 children with myopia were randomized to either treatment with low-dose atropine drops once a day before bed or a control group that was treated with placebo. The 2 groups were matched for age and sex. The patients were evaluated every 3 months over the course of 1 year at which times the changes in the spherical equivalent and axial length were measured. The investigators also evaluated the near vision, pupillary size, and the keratometry and pachymetry values at each follow-up visit.

The researchers reported that the mean changes in the spherical equivalent refraction and axial length were significantly lower in the atropine group compared with the placebo group (0.31 ± 0.55 diopter [D] and 0.11 ± 0.22 mm versus 0.80 ± 1.65 D and 0.23 ± 0.44 mm, respectively). The differences reached significance, P = 0.003).

The atropine group also had less steepening of the corneal curvature (0.16 ± 0.28 D versus 0.29 ± 0.3 D; P < 0.001). The mean changes in pachymetry were comparable between the groups (0.00 ± 0.01) (P = 0.489).

The atropine drops did not cause significant changes in the near vision or the pupillary size. Sharma reported that 96% of the eyes treated with atropine had no change in near vision; 2% of the eyes had a 1-line change in near vision (P = 0.500); and 2% had a 3-line change in near vision (P = 0.07).

They authors concluded, “The use of 0.01% atropine eye drops reduced the progression of myopia over the study period of 1 year with no significant changes in near vision and pupillary size. No patient reported any systemic and local side effects with administration of 0.01% atropine eye drops.”

Reference

1. Sharma I, Das GK, Rohatgi J, et al. Low dose atropine in preventing the progression of childhood myopia: a randomised controlled trial. Curr Eye Res. 2023;48:402-7; https://doi.org/10.1080/02713683.2022.2162925