Safety and efficacy of atropine treatment for slowing myopia progression in children: a 5-year review
Keywords:Atropine, Axial length, eye, Myopia, Refractive errors
Aim: To report the efficacy and safety of atropine treatment (0.01% and 0.125%) in slowing myopia progression in children.
Methods: This is a retrospective non-interventional case series. All patients aged <18 years who received topical atropine for myopia control from 2011 to 2016 in the Hong Kong Sanatorium & Hospital were included for analysis. Myopia progression, atropine treatment, and other factors affecting treatment outcomes were analyzed. We also reported any adverse effects associated with atropine use.
Results: A total of 346 patients were recruited, with mean a follow-up period of 2.26±0.82 years. The patients had a mean reduction of myopia progression of 68.4% after atropine treatment (p<0.001). The mean myopia progression rate (in spherical equivalent) was -0.38±0.36 D/year, and the mean axial length elongation rate was 0.23±0.19 mm/year. More reduction of myopia progression was associated with baseline myopia progression of <-1 D/year (p<0.001) and initial atropine dosage of 0.125% (p<0.001). Reduction of myopia
progression was associated with starting age (p=0.041) and baseline myopia progression (p=0.004). Patients aged <6 years who received atropine treatment (n=17) showed reduction of myopia progression by 71.1%. Only mild adverse effects such as photophobia were reported.
Conclusion: Topical atropine is an efficacious and safe treatment for slowing myopia progression.
Chia A, Chua WH, Cheung YB, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology 2012;119:347-54.
Saw SM, Tong L, Chua WH, et at. Incidence and progression of myopia in Singaporean school children. Invest Ophthalmol Vis Sci 2005;46:51-7.
Fan DS, Lam DS, Lam RF, et al. Prevalence, incidence, and progression of myopia of school children in Hong Kong. Invest Ophthalmol Vis Sci 2004;45:1071-5.
Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network meta-analysis. Ophthalmology 2016;123:697-708.
Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006;113:2285-91.
Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology 2019;126:113-24.
Gong Q, Janowski M, Luo M, et al. Efficacy and adverse effects of atropine in childhood myopia: a meta-analysis. JAMA Ophthalmol 2017;135:624-30.
Lin HJ, Wan L, Chen WC, Lin JM, Lin CJ, Tsai FJ. Muscarinic acetylcholine receptor 3 is dominant in myopia progression. Invest Ophthalmol Vis Sci 2012;53:6519-25.
Barathi VA, Kwan JL, Tan QS, et al. Muscarinic cholinergic receptor (M2) plays a crucial role in the development of myopia in mice. Dis Model Mech 2013;6:1146-58.
Lam CS, Edwards M, Millodot M, Goh WS. A 2-year longitudinal study of myopia progression and optical component changes among Hong Kong schoolchildren. Optom Vis Sci 1999;76:370-80.
How to Cite
Copyright (c) 2020 Hong Kong Journal of Ophthalmology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal has a fully Open Access policy and publishes all articles under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. For any use other than that permitted by this license, written permission must be obtained from the Journal.