Purpose: Atropine 0.01% eyedrops have been shown to slow childhood myopic progression in primarily Asian populations. We studied its effects on an ethnically diverse population over a broad range of myopia.
Methods: A retrospective case-control study was performed on 60 children (6-15 years) with initial myopic spherical equivalents from -0.25 to -8.00 diopters (D). The primary outcome was the rate of myopic progression per year. Secondary outcomes were the proportion of subjects with slow or rapid myopic progression, atropine-related side effects, and rates of myopic progression for subgroups with low, moderate, or higher initial myopia.
Results: The average initial age (10.2 years) and refraction (-2.0 D) were identical between groups. After 1.1±0.3 years follow-up, atropine subjects had significantly lower rates of myopic progression (-0.1±0.6 D/year) than controls (-0.6±0.4 D/year) (P=0.001), including 24 of 32 (75%) with slow progression ≤-0.25 D/year versus only 5 of 28 (18%) controls. Three atropine and 4 control subjects had rapid progression ≥-1.00 D/year. For subjects with low initial myopia (≤-1.00 D), 9 of 11 (82%) atropine subjects had plano or slightly hyperopic refractive changes after 1 year, while 8 of 8 (100%) controls were more myopic. Only 3 atropine subjects complained of intermittent blur or light sensitivity, not symptomatic enough to discontinue treatment.
Conclusions: Atropine 0.01% significantly reduced the rate of myopic progression over 1 year with minimal side effects. It appears most effective in children with low initial myopia and may not control rapid myopic progression in some patients. Stronger concentrations of atropine may be required to slow rapid myopic progression.