Atropine 0.05% effective in delaying myopia progression in children
Treatment with atropine eye drops confers concentration-dependent myopia control effects in children, according to the results of the LAMP* trial. Specifically, the 0.05% concentration shows superiority in controlling spherical equivalent (SE) progression and axial length (AL) elongation over a 1-year follow-up as compared with the 0.025% and 0.01% concentrations.
A total of 438 children aged 4–12 years with myopia of at least −1.0 dioptre (D) and astigmatism of −2.5 D or less were randomized (1:1:1:1) to receive atropine eye drop at 0.05%, 0.025% or 0.01% or placebo eye drop once nightly to both eyes for 12 months. Cycloplegic refraction, AL, accommodation amplitude, pupil diameter and best-corrected visual acuity were assessed at baseline, week 2, and months 4, 8 and 12. Visual Function Questionnaire was administered at the end of treatment at 1 year.
Respective mean changes in SE and AL at 1 year, the primary study endpoint, were −0.27 D and 0.20 mm in the 0.05% atropine group, −0.46 D and 0.29 mm in the 0.025% group, −0.59 D and 0.36 mm in the 0.01% group, and −0.81 D and 0.41 mm in the placebo group (p<0.001). Corresponding reduction in accommodation amplitude were 1.98, 1.61, 0.26 and 0.32 D (p<0.001).
Pupil sizes under photopic and mesopic conditions increased respectively by 1.03 and 0.58 mm in the 0.05% atropine group, 0.76 and 0.43 mm in the 0.025% group, 0.49 and 0.23 mm in the 0.01% group, and 0.13 and 0.02 mm in the placebo group (p<0.001).
Visual acuity and vision-related quality of life were not affected in all treatment groups.
LAMP demonstrates that low-concentration atropine eye drops (0.05%, 0.025% and 0.01%) delay myopia in a concentration-dependent fashion, researchers said. Moreover, all atropine concentrations are well tolerated without apparent adverse effect on the quality of life.
Additional studies are warranted to explore the antimyopia mechanism of low-concentration atropine.
*Low-Concentration Atropine for Myopia Progression