title: Atropine for the treatment of childhood myopia.
abstract: 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.
authors.affiliation: Singapore National Eye Centre, Singapore. eyesnec@gmail.com
authors.forename: Wei-Han
authors.initials: WH
authors.lastname: Chua
authors.forename: Vivian
authors.initials: V
authors.lastname: Balakrishnan
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Louis
authors.initials: L
authors.lastname: Tong
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Ling
authors.forename: Boon-Long
authors.initials: BL
authors.lastname: Quah
authors.forename: Donald
authors.initials: D
authors.lastname: Tan
mesh_terms: 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
chemical_list: D018727:Muscarinic Antagonists; D009883:Ophthalmic Solutions; D001285:Atropine