Combining low-dose atropine with optical interventions was associated with less first-year axial elongation in children with myopia than 0.01% atropine alone, according to a study. However, the combination did not achieve the degree of axial growth control observed with higher-dose atropine monotherapy, according to a review of 62 clinical studies.
The analysis included 5,769 children with a median age of 9.7 years who received myopia control interventions. Researchers examined 12-month axial elongation among children treated with atropine alone at various concentrations or with 0.01% atropine combined with orthokeratology, peripheral defocus spectacle lenses, or multifocal contact lenses. Untreated controls included 3,097 children across 37 study arms.
Median axial elongation was 0.36 mm/year among untreated children, compared with 0.26 mm/year with 0.01% atropine monotherapy and 0.15 mm/year with combination therapy. Higher-dose atropine produced greater reductions in axial elongation, with median rates of 0.08 mm/year for 0.5% atropine and 0.03 mm/year for 1% atropine.
Reference
Polling JR, van Hemert DJ, Zebari H, et al. Monotherapy or combination therapy for myopia control: a structured narrative comparison of 12-month axial elongation. Strabismus. 2026;34(sup1):88-94. doi: 10.1080/09273972.2026.2649755. Epub 2026 Aug 19. PMID: 42616355.
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