Use of Atropine for Prevention of Childhood Myopia Progression in Clinical Practice
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Published on: April 3, 2016
Kendrick Co Shih1, Tommy Chung-Yan Chan, Alex Lap-Ki Ng
1Department of Ophthalmology (K.C.S., T.C.-Y.C., A.L.-K.N., J.S.-M.L., W.W.-T.L., A.C.-K.C., D.S.-P.F.), LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Department of Ophthalmology (T.C.-Y.C.), Hong Kong Eye Hospital, Hong Kong, China; Department of Ophthalmology (W.W.-T.L., A.C.-K.C., D.S.-P.F.), Hong Kong Sanatorium and Hospital, Hong Kong, China; and Department of Ophthalmology and Visual Sciences (A.C.-K.C., D.S.-P.F.), The Chinese University of Hong Kong, Hong Kong, China.
Objective:
The most effective strategy to reduce myopia-related complications is to prevent myopia progression during childhood. This review article examines the latest published evidence on the use of atropine in childhood myopia control and discusses practical aspects of applying the findings to clinical practice. Future directions including possible forms of combination therapy are examined.
Methods:
A literature search with a focus on randomized controlled trials (RCTs) and meta-analyses on the subject was conducted. Observational studies with control groups were also reviewed to discuss issues regarding feasibility of using atropine for myopia control in clinical practice.
Results:
Five RCTs and 2 meta-analyses were found. The studies all found beneficial effects of atropine in myopia control, as well as a clear but perhaps clinically insignificant dose-response relationship between atropine and myopia progression rates. Available evidence however is focused on predominantly Chinese populations, and there is a current lack of guidance on timing of therapy initiation, duration of therapy, and treatment cessation. For future directions, combining atropine with other forms of myopia control would be worth considering.
Conclusions:
Atropine is robust option for childhood myopia control. Further evidence including RCTs in different populations as well as the upcoming 5-year atropine for the treatment of myopia 2 trial results will provide much needed answers for wider acceptance of its use.
Insights
Low-dose atropine eye drops are effective for controlling childhood myopia progression. Further research is needed to establish optimal usage guidelines and explore combination therapies for myopia management.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Childhood myopia progression increases the risk of serious ocular complications.
- Preventing myopia progression in children is crucial for long-term eye health.
Purpose of the Study:
- To review current evidence on atropine for childhood myopia control.
- To discuss practical clinical applications and future research directions for atropine therapy.
Main Methods:
- Literature search focused on randomized controlled trials (RCTs) and meta-analyses.
- Included observational studies to assess clinical feasibility of atropine use.
Main Results:
- Five RCTs and two meta-analyses confirmed atropine's efficacy in myopia control.
- A dose-response relationship was observed, though its clinical significance is debated.
- Evidence is primarily from Chinese populations, with limited guidance on treatment protocols.
Conclusions:
- Atropine is a viable option for managing childhood myopia.
- Further RCTs in diverse populations and trial results are necessary for broader clinical adoption.
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