Prevention of Myopia Progression with 0.05% Topical Atropine: 2-Year Results in a Portuguese Cohort

Authors

  • Madalena Sousa Gonçalves Ophthalmology Department, ULS Loures Odivelas, Hospital Beatriz Ângelo, Loures, Portugal https://orcid.org/0000-0002-1313-4847
  • Margarida Brízido Ophthalmology Department, ULS Almada Seixal, Hospital Garcia de Orta, Almada, Portugal
  • Florence Aerts Ophthalmology Department, ULS Loures Odivelas, Hospital Beatriz Ângelo, Loures, Portugal
  • Filipa Ching Pharmacy Department, ULS Loures Odivelas Hospital Beatriz Ângelo, Loures, Portugal
  • Ana Rita Azevedo Ophthalmology Department, ULS Loures Odivelas, Hospital Beatriz Ângelo, Loures, Portugal
  • Ana C. Almeida Ophthalmology Department, ULS Loures Odivelas, Hospital Beatriz Ângelo, Loures, Portugal

DOI:

https://doi.org/10.48560/rspo.38890

Keywords:

Administration, Topical, Atropine/administration & dosage, Child, Myopia/drug therapy

Abstract

INTRODUCTION: Myopia is considered by many an emerging public health challenge. Different forms of treatment have been proposed to treat myopia progression, one of them being topical atropine. The purpose of our study was to evaluate the efficacy and safety of 0.05% atropine eyedrops in controlling myopia progression in a cohort of Portuguese children over 2 years.

METHODS: Children aged 4 to 16 years old with myopic refraction of at least -1.00 dioptre (D) and myopia progression of ≥ -0.50 D/year were enrolled in this prospective non-randomized interventional single-center study. Patients were prescribed 0.05% atropine eye drops to be applied once nightly to both eyes over a period of 2 years. Outcome measures were change in spherical equivalent (SE) and axial length (AL) over 2 years.

RESULTS: Of the 55 children enrolled in the study, 24 children have completed 2 years of treatment (12 female). At the 2-year follow-up, mean SE was -5.76 (±2.36) D and mean AL was 25.27 (±1.08) mm. Change of SE from baseline was -0.47 (±0.50) D and AL change from baseline was 0.31 (±0.27) mm. After 2 years of treatment, 5 children showed no progression on SE and AL and discontinued treatment, with a mean change of SE of 0.175 D and AL of 0.10 mm. None of the patients who completed the 2-year follow-up reported adverse effects.

CONCLUSION: In this cohort, 0.05% atropine eye drops were safe, well-tolerated and effectively retarded progression of SE and AL.

Downloads

Download data is not yet available.

References

Zhu Q, Tang GY, Hua ZJ, Xue LP, Zhou Y, Zhang JY, et al. 0.05% atropine on control of myopia progression in Chinese school children: a randomized 3-year clinical trial. Int J Ophthalmol. 2023;16:939-46. doi: 10.18240/jjo.2023.06.17.

Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridung P, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123:1036-42. doi: 10.1016/j.ophtha.2016.01.006.

World Health Organization - The Impact of Myopia and High Myopia In: Myopia. WHO Library. Geneve: WHO;2016;

Kleinstein RN, Jones LA, Hullett S, Kwon S, Lee RJ, Friedman NE, et al. Refractive error and ethnicity in children. Arch Ophthalmol. 2003;121:1141-7. doi: 10.1001/archopht.121.8.1141.

Agyekum S, Chan PP, Zhang Y, Huo Z, Yip BH, Ip P, et al. Cost-effectiveness analysis of myopia management: A systematic review. Front Public Health. 2023;11:1093836. doi: 10.3389/fpubh.2023.1093836.

Yam JC, Jiang Y, Tang SM, Law AK, Chan JJ, Wong E, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019;126:113-24. doi: 10.1016/j.ophtha.2018.05.029.

Li FF, Kam KW, Zhang Y, Tang SM, Young AL, Chen LJ, et al. Differential Effects on Ocular Biometrics by 0.05%, 0.025%, and 0.01% Atropine: Low-Concentration Atropine for Myopia Progression Study. Ophthalmology. 2020;127:1603-11. doi: 10.1016/j.ophtha.2020.06.004.

Chierigo A, Ferro Desideri L, Traverso CE, Vagge A. The Role of Atropine in Preventing Myopia Progression: An Update. Pharmaceutics. 2022;14:900. doi: 10.3390/pharmaceutics14050900.

Ha A, Kim SJ, Shim SR, Kim YK, Jung JH. Efficacy and Safety of 8 Atropine Concentrations for Myopia Control in Children: A Network Meta-Analysis. Ophthalmology. 2022;129:322-33. doi: 10.1016/j.ophtha.2021.10.016.

Chia A, Chua WH, Cheung YB, Wong WL, Lingham A, Fong A, et al. Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology. 2012;119:347-54. doi: 10.1016/j.ophtha.2011.07.031.

Yam JC, Zhang XJ, Zhang Y, Yip BH, Tang F, Wong ES, et al. Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children: The LAMP2 Randomized Clinical Trial. JAMA. 2023;329:472-81. doi: 10.1001/jama.2022.24162. Erratum in: JAMA. 2023;329:1123. doi: 10.1001/jama.2023.3989.

Yam JC, Zhang XJ, Zhang Y, Wang YM, Tang SM, Li FF, et al. Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression (LAMP) Study: Continued Versus Washout: Phase 3 Report. Ophthalmology. 2022;129:308-21. doi: 10.1016/j.ophtha.2021.10.002.

Zhang XJ, Zhang Y, Yip BH, Kam KW, Tang F, Ling X, et al. Five-Year Clinical Trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: Phase 4 Report. Ophthalmology. 2024;131:1011-20. doi: 10.1016/j.ophtha.2024.03.013.

Zadnik K, Schulman E, Flitcroft I, Fogt JS, Blumenfeld LC, et al; CHAMP Trial Group Investigators. Efficacy and Safety of 0.01% and 0.02% Atropine for the Treatment of Pediatric Myopia Progression Over 3 Years: A Randomized Clinical Trial. JAMA Ophthalmol. 2023;141:990-9. doi: 10.1001/jamaophthalmol.2023.2097. Erratum in: JAMA Ophthalmol. 2023;141:1005. doi: 10.1001/jamaophthalmol.2023.4206.

Repka MX, Weise KK, Chandler DL, Wu R, Melia BM, Mamry RE, et al. Low-Dose 0.01% Atropine Eye Drops vs Placebo for Myopia Control: A Randomized Clinical Trial. JAMA Ophthalmol. 2023;141:756-65. doi: 10.1001/jamaophthalmol.2023.2855.

Loughman J, Kobia-Acquah E, Lingham G, Butler J, Loskutova E, Mackey DA, et al. Myopia outcome study of atropine in children: Two-year result of daily 0.01% atropine in a European population. Acta Ophthalmol. 2024;102:e245-56. doi: 10.1111/aos.15761.

Tsai HR, Wang JH, Huang HK, Chen TL, Chen PW, Chiu CJ. Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis. J Formos Med Assoc. 2022;121:2490-500. doi: 10.1016/j.jfma.2022.05.005.

Nucci P, Lembo A, Schiavetti I, Shah R, Edgar DF, Evans BI. A comparison of myopia control in European children and adolescents with defocus incorporated multiple segments (DIMS) spectacles, atropine, and combined DIMS/atropine. PLoS One. 2023;18:e0281816. doi: 10.1371/journal.pone.0281816.

Lam CS, Tang WC, Tse DY, Lee RP, Chun RK, Hasegawa K, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. Br J Ophthalmol. 2020;104:363-8. doi: 10.1136/bjophthalmol-2018-313739.

Lanca C, Pang CP, Grzybowski A. Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021. Front Public Health. 2024;12:1460156. doi: 10.3389/fpubh.2024.1460156.

Huang Z, Chen XF, He T, Tang Y, Du CX. Synergistic effects of defocus-incorporated multiple segments and atropine in slowing the progression of myopia. Sci Rep. 2022;12:22311. doi: 10.1038/s41598-022-25599-z. Erratum in: Sci Rep. 2023;13:9650. doi: 10.1038/s41598-023-36663-7.

Cao X, Guo Z, Wei Z, Ming H, Ma B, Zhao Y, et al. Effect of 0.01% atropine eye drops combined with different optical treatments to control low myopia in Chinese children. Cont Lens Anterior Eye. 2025;48:102317. doi: 10.1016/j.clae.2024.102317.

Guimaraes S, Barros da Silva P, Oliveiros B, Silva E. Myopia control: short-term effect of 0.01% atropine vs. defocus incorporated multiple segment lenses-a retrospective study in European children. Int Ophthalmol. 2023;43:3777-84. doi: 10.1007/s10792-023-02788-x.

Tariq F, Mobeen R, Wang X, Lin X, Bao Q, Liu J, et al. Advances in myopia prevention strategies for school-aged children: a comprehensive review. Front Public Health. 2023;11:1226438. doi: 10.3389/fpubh.2023.1226438.

Downloads

Published

2025-06-05

How to Cite

Sousa Gonçalves, M., Brízido, M., Aerts, F., Ching, F., Azevedo, A. R., & Almeida, A. C. (2025). Prevention of Myopia Progression with 0.05% Topical Atropine: 2-Year Results in a Portuguese Cohort. Revista Sociedade Portuguesa De Oftalmologia, 49(4), 329–334. https://doi.org/10.48560/rspo.38890

Issue

Section

Original Article