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Randomized Controlled Trial
. 2022 Dec;50(9):1001-1012.
doi: 10.1111/ceo.14148. Epub 2022 Sep 9.

Low-concentration atropine eyedrops for myopia control in a multi-racial cohort of Australian children: A randomised clinical trial

Samantha Sze-Yee Lee  1 , Gareth Lingham  1   2 , Magdalena Blaszkowska  1 , Paul G Sanfilippo  3 , Adrian Koay  1   4 , Maria Franchina  1 , Audrey Chia  5   6 , James Loughman  2 , Daniel Ian Flitcroft  7 , Christopher J Hammond  8 , Augusto Azuara-Blanco  9 , Julie M Crewe  1 , Antony Clark  1 , David A Mackey  1   3   10
Affiliations
Randomized Controlled Trial

Low-concentration atropine eyedrops for myopia control in a multi-racial cohort of Australian children: A randomised clinical trial

Samantha Sze-Yee Lee et al. Clin Exp Ophthalmol. 2022 Dec.

Abstract

Background: To test the hypothesis that 0.01% atropine eyedrops are a safe and effective myopia-control approach in Australian children.

Methods: Children (6-16 years; 49% Europeans, 18% East Asian, 22% South Asian, and 12% other/mixed ancestry) with documented myopia progression were enrolled into this single-centre randomised, parallel, double-masked, placebo-controlled trial and randomised to receive 0.01% atropine (n = 104) or placebo (n = 49) eyedrops (2:1 ratio) instilled nightly over 24 months (mean index age = 12.2 ± 2.5 and 11.2 ± 2.8 years, respectively). Outcome measures were the changes in spherical equivalent (SE) and axial length (AL) from baseline.

Results: At 12 months, the mean SE and AL change from baseline were -0.31D (95% confidence interval [CI] = -0.39 to -0.22) and 0.16 mm (95%CI = 0.13-0.20) in the atropine group and -0.53D (95%CI = -0.66 to -0.40) and 0.25 mm (95%CI = 0.20-0.30) in the placebo group (group difference p ≤ 0.01). At 24 months, the mean SE and AL change from baseline was -0.64D (95%CI = -0.73 to -0.56) and 0.34 mm (95%CI = 0.30-0.37) in the atropine group, and -0.78D (95%CI = -0.91 to -0.65) and 0.38 mm (95%CI = 0.33-0.43) in the placebo group. Group difference at 24 months was not statistically significant (p = 0.10). At 24 months, the atropine group had reduced accommodative amplitude and pupillary light response compared to the placebo group.

Conclusions: In Australian children, 0.01% atropine eyedrops were safe, well-tolerated, and had a modest myopia-control effect, although there was an apparent decrease in efficacy between 18 and 24 months, which is likely driven by a higher dropout rate in the placebo group.

Keywords: atropine; axial length; myopia; myopia control; randomised controlled trial.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Estimated marginal mean change in spherical equivalent (left) and axial length (right) from baseline. Statistically different from the placebo group at *p < 0.05 or **p < 0.01. Estimates are adjusted for baseline value; error bars represent standard error
See this image and copyright information in PMC

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