Low dose atropine eye drops significantly slow myopia progression in children with fewer side effects than higher doses, finds a five-year study by researchers in Singapore.
The findings were presented at the annual meeting of the American Academy of Ophthalmology (AAO), which was held in Las Vegas earlier this month (14–17 November). The researchers say that while further study is needed, the results suggest that low dose atropine eye drops are safe enough to use in children for up to five years.
As part of the study, which started in 2006, 400 myopic children aged 6–12 received nightly eye drops of either 0.5%, 0.1% or 0.01% atropine for two years. After 12 months, the treatment was stopped, and those children whose myopia progressed by 0.5D or more continued 0.01% atropine for a further two years.
The researchers found that after five years, the low dose (0.01%) atropine group were the least myopic compared to higher dose groups, with the low dose atropine found to slow myopia progression by 50% compared to those children not treated with the medication in an earlier study.
The low dose atropine group also recorded fewer unwanted side effects associated with higher concentrations of the drug, including dilated pupils, which leads to increased light sensitivity and blurred vision.
Lead investigator and professor of ophthalmology at the Singapore Eye Research Institute, Dr Donald T. Tan, said: “For a long time we‘ve known that atropine drops can keep myopia from getting worse to some degree.”
Dr Tan added: “We now have data showing that it is not only effective, but also safe. Combined with other interventions, this treatment could become a great ally in preventing myopia from causing serious visual impairment in children worldwide.”
However, the group also reported that approximately 9% of children failed to respond to treatment in the first two years. The investigators suggest that more research is needed to establish which children would make good candidates for treatment and to determine when to start treatment and for how long.
Commenting on the findings, which were published in Ophthalmology earlier this year, senior lecturer in optometry at Aston University, Dr Nicola Logan, said that the five-year data show “significant reductions in the short-term side effects of blurred near vision and dilated pupils that require the use of reading spectacles and photochromic lenses with the higher doses.”
Dr Logan told OT: “There is also a marked reduction in the rebound effect that is found on cessation of treatment with higher doses of atropine. This study certainly provides further evidence for the use of atropine for myopia control.”
The researcher, who is also the convener of the Myopia Consortium UK, added: “However, longer-term follow-up is still required on the long-term side effects of using atropine and there are some limitations to the ATOM study principally in the lack of a good control group. Most studies using atropine for myopia control have been carried out on children of Chinese origin, there is need for a study on children of European ancestry to assess whether children with light coloured irises respond in a similar way especially in relation to the side effects.”