Atropine for the treatment of childhood myopia.
OBJECTIVE
To evaluate the efficacy and safety of topical atropine, a nonselective muscarinic antagonist, in slowing the progression of myopia and ocular axial elongation in Asian children.


METHODS
Parallel-group, placebo-controlled, randomized, double-masked study.


METHODS
Four hundred children aged 6 to 12 years with refractive error of spherical equivalent -1.00 to -6.00 diopters (D) and astigmatism of -1.50 D or less.


METHODS
Participants were assigned with equal probability to receive either 1% atropine or vehicle eye drops once nightly for 2 years. Only 1 eye of each subject was chosen through randomization for treatment.


METHODS
The main efficacy outcome measures were change in spherical equivalent refraction as measured by cycloplegic autorefraction and change in ocular axial length as measured by ultrasonography. The primary safety outcome measure was the occurrence of adverse events.


RESULTS
Three hundred forty-six (86.5%) children completed the 2-year study. After 2 years, the mean progression of myopia and of axial elongation in the placebo-treated control eyes was -1.20+/-0.69 D and 0.38+/-0.38 mm, respectively. In the atropine-treated eyes, myopia progression was only -0.28+/-0.92 D, whereas the axial length remained essentially unchanged compared with baseline (-0.02+/-0.35 mm). The differences in myopia progression and axial elongation between the 2 groups were -0.92 D (95% confidence interval, -1.10 to -0.77 D; P<0.001) and 0.40 mm (95% confidence interval, 0.35-0.45 mm; P<0.001), respectively. No serious adverse events related to atropine were reported.


CONCLUSIONS
Topical atropine was well tolerated and effective in slowing the progression of low and moderate myopia and ocular axial elongation in Asian children.
Chua
Wei-Han
WH
Singapore National Eye Centre, Singapore. eyesnec@gmail.com
Balakrishnan
Vivian
V
Chan
Yiong-Huak
YH
Tong
Louis
L
Ling
Yvonne
Y
Quah
Boon-Long
BL
Tan
Donald
D
D000287:Administration, Topical; D001251:Astigmatism / Q000188:drug therapy / Q000503:physiopathology; D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D009216:Myopia / Q000188:drug therapy* / Q000503:physiopathology; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D012029:Refraction, Ocular / Q000502:physiology
D018727:Muscarinic Antagonists; D009883:Ophthalmic Solutions; D001285:Atropine