Research Review

Myopia Progression After Cessation of Low-Dose Atropine Treatment

October 3, 2022

By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE

Many eye care professionals have expressed concern about rebound after children and adolescents have applied topical low-dose atropine for myopia control. To address this concern, Wei, et al. conducted a randomized, double-masked, placebo-controlled, cross-over trial. The study aimed to evaluate myopia progression and axial elongation after stopping 0.01% atropine eye drops through a two-year cross-over study.

A total of 133 subjects completed two years of follow-up. In the first year, the mean myopia progression in the atropine-placebo group was 0.21 ± 0.08D slower than in the placebo-atropine group. After cross-over treatment, the mean myopia progression in the atropine-placebo group was 0.22 ± 0.07D faster than in the placebo-atropine group in the second year. Over two years, the mean myopia progression was -1.26 ± 0.66D and -1.25 ± 0.70D in the atropine-placebo and placebo-atropine groups (p = 0.954).

The researchers concluded that the difference in myopia progression between the atropine-placebo and placebo-atropine groups in Phase 1 was similar to Phase 2 during the cross-over treatment. This cross-over trial suggests no rebound effect after using 0.01% atropine eye drops to prevent myopia progression.

 

Abstract

Myopia Progression After Cessation of Low-Dose Atropine Eyedrops Treatment: A Two-Year Randomized, Double-Masked, Placebo-Controlled, Cross-Over Trial

Shifei Wei, Shi-Ming Li, Wenzai An, Jialing Du, Xintong Liang, Yunyun Sun, Jiahe Gan, Weiling Bai, Jiaxin Tian, Zhining Cai, Lei Yin, Ningli Wang

Purpose: The purpose of the study was to evaluate myopia progression and axial elongation after stopping 0.01% atropine eye drops through a 2-year cross-over study.

Methods: This study was a randomized, double-masked, placebo-controlled, cross-over trial in mainland China. 220 children aged 6-12 years with spherical equivalent range of -1.00 D to -6.00 D in both eyes were enrolled in Phase 1 for 1 year. Children who had completed the first year’s follow-up continued in the second phase. In Phase 2, the placebo group was crossed over to the 0.01% atropine group (referred to as the ‘placebo-atropine group’), and the 0.01% atropine group was crossed over to the placebo group (referred to as the ‘atropine-placebo group’). All children underwent the examination of cycloplegic refraction and axial length at a 6-month interval. Only data from right eyes were included in the analysis.

Results: One hundred thirty-three subjects completed 2 years of follow-up. In the first year, the mean myopia progression in the atropine-placebo group was 0.21 ± 0.08 D slower than in the placebo-atropine group. After cross-over treatment, the mean myopia progression in the atropine-placebo group was 0.22 ± 0.07D faster than in the placebo-atropine group in the second year. Over 2 years, the mean myopia progression was -1.26 ± 0.66D and -1.25 ± 0.70D in the atropine-placebo and placebo-atropine groups (p = 0.954).

Conclusions: The difference in myopia progression between atropine-placebo group and placebo-atropine group in Phase 1 was similar to Phase 2 during the cross-over treatment. Through our cross-over trial, the results suggest that there is no rebound effect after using 0.01% atropine eye drops to prevent the progression of myopia.

Wei, S., Li, S. M., An, W., Du, J., Liang, X., Sun, Y., … & Wang, N. (2022). Myopia progression after cessation of low‐dose atropine eyedrops treatment: A two‐year randomized, double‐masked, placebo‐controlled, cross‐over trial. Acta Ophthalmologica.

DOI: https://doi.org/10.1111/aos.15235

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