Efficacy of atropine for myopia control in children: A meta-analysis of randomized controlled trials

To conduct a meta-analysis of randomized controlled trials (RCTs) on the effects of atropine eye drop in slowing myopia progression.

A systematic search of relevant articles was done through a computerized search on PubMed, Medline, Cochrane Library, and Google Scholar on June 16, 2022. A supplementary search was done on ClinicalTrials.gov on the same date. After thorough search and analysis, seven relevant RCTs, double-masked with atropine eye drop as intervention arm and placebo as control arm, were selected for meta-analysis. Jadad scoring was used to evaluate the quality of RCTs. The outcome measurements included in the present meta-analysis are mean changes in the spherical equivalent (SE) of myopic error, and mean changes in axial length (AL) during the study period.

Pooled summary effect size, calculated by random effect model, for SE of myopia progression was 1.08 with 95% confidence interval (CI) (0.31-1.86) which was statistically significant (P-value = 0.006). Pooled summary effect size, calculated by random effect model, for axial length was - 0.89 with 95% CI (-1.48 to - 0.30) which was statistically significant (P-value = 0.003).

In summary, atropine was demonstrated to be effective in controlling myopia progression in children. Both outcome measures, mean SE changes and mean AL elongation responded to atropine intervention compared to placebo.