Assessing Low-Concentration Atropine in Myopia Progression: A Systematic Review

Objective: Low-concentration atropine (LCA) eye drop is used as a promising treatment for the management of myopia but its effectiveness has not been widely evaluated. Therefore, this study aimed to analyze the efficacy of LCA eye drop for myopia progression. Materials and Methods: This review was conducted following the PRISMA guidelines and a comprehensive literature search was performed on 3 online databases including PubMed, Cochrane, and ProQuest. The keywords used included ‘Low-concentration atropine eye drop’, ‘Atropine’, ‘Eye Drop’, ‘Myopia’, and their Mesh. All studies included were available in English and full-text format. Myopia progression rates were analyzed from all studies, and Rayyan, an online-based tool was used in the screening process. Results: The results showed that 3 randomized control trials (RCT), 2 cohort studies, and 3 case reports with a total of 1389 participants were analyzed. The majority studies were conducted in Asia, while one RCT was performed in Australia. The participants ranged from 4-12 years old, while atropine eye drop concentrations used were 0.01%, 0.025%, 0.05%, 0.1%, 0.125%, and 0.2%. All studies showed a slower progression rate of myopia in the atropine group compared to the control (-0.31 D vs. -0.90 D; -0.05 D vs. -1.05 D; -0.27 D vs. -0.81 D; -0.28 D vs. -0.54 D; -0.36 D vs. -0.90 D;−0.31 D vs. −0.76 D; -0.31 vs. -0.53 D; -0.38 D vs. -0.55 D) with P < 0.05. Conclusion: LCA eye drop showed promising effects in slowing myopia progression. However, further investigation is needed, particularly in non-Asian countries.