Low-dose atropine eye drops slow progression of myopia in children

Issue: January 2016

LAS VEGAS — A low-dose formulation of atropine slowed the progression of myopia in a 5-year clinical trial, a speaker told colleagues at the American Academy of Ophthalmology meeting here.

“We think we can prevent myopic progression both safely and effectively in children for the first time. A 0.01% once-a-day [dose] appears to be able to reduce that amount of progression by about 50%,” Donald Tan, MD, said during a press briefing on “Innovations in vision: Nanotech, nearsightedness and neuro-ophthalmology imaging.”

In 1999, Tan and colleagues at the Singapore National Eye Center conducted the Atropine for the Treatment of Myopia 1 (ATOM1) study. While a 1% dose of atropine stopped the eyeball from growing longer and minimized progression of myopia by 77%, progression continued after treatment was stopped.

The ATOM2 trial included 400 children ranging in age from 6 years to 12 years (mean: 9.7 years) with at least 2 D of myopia. Mean spherical equivalent refraction was –4.7 D.

Children were randomized to receive a bilateral 0.5% dose of atropine (161 patients), 0.1% dose of atropine (155 patients) or 0.01% dose of atropine (84 patients).

Patients received the eye drops for 2 years, followed by a 1-year washout period and a 2-year follow-up period.

After 3 years, myopia progressed in 68% of eyes in the 0.5% group and 24% of eyes in the 0.01% group.

“The higher the concentration, the worse it is when you stop,” Tan said. “The lower the concentration, there’s almost no rebound effect.”

There were no reports of serious adverse events; glare was reported among 1% of patients, Tan said.

Tan and colleagues at the Singapore National Eye Center subsequently launched myopia control clinics for children. So far, myopia has progressed only 0.6 D among 386 children treated with atropine in the clinics, Tan said. – by Matt Hasson

Disclosure: Tan reports no relevant financial disclosures.