Low-dose atropine for high myopia: An observational cohort study

Purpose

To describe and compare the spherical equivalent progression of pediatric patients with high myopia undergoing treatment with 0.01 % atropine and those not receiving any myopia therapy.

Design

Retrospective, descriptive cohort study

Methods

In this IRB-approved study, we analyzed the spherical equivalent (SE) progression in children 6–13 years old treated with 0.01 % atropine and those who were not treated for myopia, initial SE of ≤-6 D, astigmatism of ≤2 D, no syndromic conditions, and records of cycloplegic refraction measurements without missing more than one year.

Results

Seventy-five eyes were included, with 87 % belonging to Hispanic patients. The baseline SE (D) was -7.66 ± 1.40 in the atropine group and -7.90 ± 1.38 in the control group. Over three years, atropine-treated eyes demonstrated slower SE progression compared to controls (P = 0.002). Analysis of yearly progression rates (D/year) revealed notably slower progression in the atropine group during the second (P = 0.04) and third (P = 0.02) years.

Conclusion

Our findings suggest that low-dose atropine may be beneficial as a first-line treatment for high myopia due to its favorable safety profile and potential efficacy. Due to limited statistical power, findings should be interpreted cautiously.