Therapeutic effect of topical 0.125% atropine in Korean myopic children: the real-world experience.

Abstract

Purpose: To evaluate the effectiveness of 0.125% atropine eye drops in controlling myopia progression by analyzing 1-year follow-up data through a multi-center retrospective study in South Korea.

Methods: A retrospective chart review was conducted across five centers, including 121 myopic children (ages 4-11) treated with 0.125% atropine between January 2021 and December 2023. An equal number of age-, sex-, axial length (AL)-, spherical equivalent (SE)-matched untreated controls were included. Baseline and follow-up data at 6 and 12 months included visual acuity, autorefraction, AL measurement (IOL-Master 700), and fundus examination. The primary outcome measures were changes in SE and AL compared to controls.

Results: Age, SE and AL in treatment group at baseline were 7.5 ± 1.5 (range: 4 - 11) years, -3.07 ± 1.65 (diopters, D) and 24.39 ± 0.85 mm (range: 22.19 - 26.94), and these parameters showed no statistical differences compared to the matched controls. SE after 1-year-treatment was less myopic in the treatment group (-3.42 ± 1.72 D vs -3.94 ± 1.92 D, P = 0.020). Similarly, AL was significantly shorter in treatment group (24.65 ± 0.88 mm) compared to controls (24.88 ± 0.80 mm, P = 0.029). The SE change from baseline was -0.33 ± 0.73 D in the treatment group versus -0.91 ± 1.01 D in controls (P < 0.001). AL increased by 0.25 ± 0.32 mm in the treatment group, significantly less than 0.49 ± 0.24 mm increase in controls (P < 0.001). Baseline AL and mean keratometry showed no correlation with AL progression (all Ps > 0.05).

Conclusion: The use of 0.125% atropine eye drops significantly reduced myopia progression, with approximately 50% reduction in AL elongation compared to controls. Given its effectiveness and variable compliance, 0.125% atropine eye drops may serve as a viable alternative to low-dose atropine for myopia control.