Atropine (0.05%) for rapid progressive childhood myopia (ARM study)

Purpose: This study aims to assess the effectiveness of atropine 0.05% for myopia control among children exhibiting (documented) rapid myopia progression (>0.75D/year).

Methods: This prospective interventional single-arm clinical trial included children aged between 6-12 years, spherical equivalent refractive (SER) error between - 2 and - 6D, and having documented myopia progression of >0.75D in the preceding year. All participants were administered atropine 0.05% in both eyes once at bedtime for 1 year. The primary outcome measure was a change in the rate of myopia progression (D/year) and change in SER and axial length (AL) at 1 year and documentation of any adverse effects related to therapy.

Results: Forty children were enrolled with a mean age of 8.5 ± 2.2 years. (45% male) The mean SER 1 year before starting atropine treatment was -3.53 ± 0.78D. At baseline, the mean SER was -4.58 ± 1.03D, which increased to -4.98 ± 0.97D after 1-year follow-up. The study reported a 62% reduction in the rate of myopia progression after 1 year of atropine 0.05% treatment (-1.05 ± 0.21D/year [baseline] to - 0.4 ± 0.14D/year[1-year follow-up] [P < 0.001]). The mean AL increased from 24.98 ± 2.43 mm (baseline) to 25.21 ± 2.32 mm (1 year). There was no significant correlation between changes in AL and SER (r: 0.57; P: 0.063). The study observed the response to treatment was independent of the age at baseline, baseline refractive error, baseline rate of progression, gender, and family history of myopia. No adverse effects from atropine 0.05% were reported.

Conclusions: Atropine 0.05% could be an effective treatment for children with rapidly progressing myopia with no significant side effects.