Atropine keeps myopia at bay in kids

High-dose atropine helps slow the progression of high myopia in kids with or at risk of developing the condition, a recent study has found.

Researchers conducted a prospective clinical effectiveness study on 124 children (median age, 9.5 years; 54 percent female) with myopia (≤–2.5 D) or progressive myopia (≥1 D per year). Atropine was given at a 0.5% concentration, and target outcomes included spherical equivalent (SER) and axial length (AL).

The median SER 1 year before the study was –3.88 D, which worsened to –5.03 D by baseline. This indicated a progression of more than 1 D before treatment. More than a third (37.1 percent) of participants had high myopia (SER ≤–6 D), and the median AL was 25.14 mm.

Eighty-nine children (71.8 percent) stated on-treatment over the 3 years of follow-up. Of these, 34.8 percent (n=31) remained on the 0.5% dose, while 36.0 percent (n=32) and 29.2 percent (n=26) saw an increase and decrease in dose, respectively. No AL rebound was reported after dose reduction.

The median annual progression of SER in patients who completed treatment was –0.25 D, while AL increased at a median rate of 0.11 mm per year. On a per-year basis, researchers saw that the progression of SER dropped to 0.00 D in year 1, –0.41 D in year 2, and –0.38 D in year 3. Relative to before treatment, these corresponded to reduction rates of 100 percent, 65 percent, and 68.2 percent (p<0.01 for all).

For those who dropped out, the most common reasons for termination were allergic reactions, photophobia, and non-eye-related adverse events.