Myopia progresses quicker after atropine treatment is stopped in children

Ophthalmology. 2009;116(3):572-579.

Long-term treatment with atropine may yield less myopia in pediatric patients, but cessation of treatment may lead to quicker development of myopia compared with placebo.

In a parallel-group, randomized, double-masked study looking at myopia progression 1 year after stopping either atropine or placebo in children aged 6 to 12 years, patients who had received atropine had a mean progression of –1.14 ± 0.8 D, higher than the –0.38 ± 0.39 D observed in the placebo group.

However, after 3 years in the trial, including 2 years of treatment and a 1-year cessation period, children treated with atropine had significantly less progression of myopia when compared with children treated with vehicle alone.

In atropine-treated eyes, the spherical equivalent was –4.29 ± 1.67 D, which compared favorably with the –5.22 ± 1.38 D in placebo-treated eyes. Axial length in the treated group was 0.29 ± 0.37 mm compared with 0.52 ± 0.45 mm in the untreated group.

"Although atropine was only used in the first 2 years of the study, the beneficial effect of the drug on myopia progression was still evident 1 year after cessation of atropine," the study authors said.

There was a brief impairment of accommodation and blurring of near vision associated with atropine use in some patients, but both returned to baseline levels within 6 months of stopping treatment. No other complications were noted in the study.

According to the study, it is not known whether the more rapid rebound effect seen in treatment eyes would mean they could catch up to untreated eyes in terms of myopia.