Safety and efficacy of atropine treatment for slowing myopia progression in children: a 5-year review

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 myopiaprogression 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.