US trial finds 0.01% atropine does not slow myopia progression

New research published in JAMA Ophthalmology has found 0.01% atropine eye drops did not slow myopia progression in a group of 187 US children.

The study group were aged between five and 12 years old, with low to moderate bilateral myopia (spherical equivalent myopia of −1.00 to −6.00 D).

Over a two-year study period, participants were randomly assigned to instil either a drop of 0.01% atropine each night or a placebo eye drop.

The researchers found that nightly low-dose atropine did not slow myopia progression when compared to placebo.

The study did not incorporate an objective measure of eye drop use and relied on family reports of compliance as well as counting returned eye drop ampules.

The results of the study differ from five clinical trials in East Asian and South Asian populations with similar age and refractive error which found beneficial effects of atropine for limiting myopia progression.

The authors suggested that this difference could be due to several factors – including lack of a two-year contemporaneous placebo control in other studies, as well as a higher level of loss to follow up.

They also highlighted that there could be racial differences in response to atropine eye drops.

“Future studies of pharmacologic myopia control in US children should consider increased atropine concentrations, new pharmaceuticals, objective measures of treatment adherence, alternative eye drop delivery systems and schedules, as well as evaluating the impact of environmental and genetic factors and optical interventions on myopia control treatment,” the authors concluded.