Short-term efficacy of increasing 0.01% atropine administration frequency in controlling myopia progression in...

To investigate the efficacy and safety of increased administration frequency of 0.01% atropine eye drops in controlling myopia progression in adolescents, thereby providing evidence for optimizing clinical myopia prevention and control strategies.

This is a retrospective one arm clinical trial. Among the 108 initially enrolled children, 37 myopic participants (37 eyes, 7-12 years old) satisfying inclusion criteria entered the study from February to August 2025. The inclusion criterion was an axial length (AL) increase of ≥ 0.1 mm after 3 consecutive months of initial 0.01% atropine eye drops treatment. A single-group pre-post control design was adopted in this study, with the intervention divided into two phases (all intervention conditions were consistent except for the administration frequency): Initial intervention phase (Months 1-3): phase 1, All subjects received 0.01% atropine eye drops once daily at night; Intensive intervention phase (Months 4-6): phase 2, Based on the evaluation that AL growth was not optimally controlled in the initial phase, the administration frequency was adjusted to twice daily. Indicators including changes in AL, average corneal curvature (ACC), intraocular pressure (IOP), amplitude of accommodation (AMP), and adverse reactions.

The AL increase in the phase 1 during the first 3 months was 0.16 ± 0.07 mm, and then AL increase in phase 2 was 0.05 ± 0.08 mm during the subsequent 3 months, with AL growth retardation rate of 70.8%, showing a statistically significant difference (P < 0.001). There were no statistically significant differences in ACC and IOP between the two groups (P > 0.05). Although the AMP slightly decreased with increased administration frequency, it remained above 10D, meeting the needs of daily near vision. The incidence of photophobia in phase 2 was 16.2% (6/37), manifested only as mild photophobia which was tolerable.

Among adolescents with poor myopia control under once-daily 0.01% atropine, increasing medication frequency to twice daily may slow AL progression without obvious safety concerns, which could serve as an alternative management option in clinical practice for myopia prevention and control.