Key Takeaways
- Atropine 0.01% to 0.05% slowed myopia progression over 2 years with minimal post-treatment rebound.
- Higher-dose atropine and repeated low-intensity red-light therapy had greater short-term efficacy but meaningful rebound after treatment cessation.
Atropine eye drops at concentrations of 0.01% to 0.05% slowed pediatric myopia progression over 2 years and were not associated with clinically meaningful rebound after treatment cessation, according to a study.
The systematic review identified 117 randomized controlled trials evaluating 24 active interventions. After exclusions for missing outcomes or violations of the transitivity assumption, 22 trials and 1 study arm were omitted from quantitative synthesis.
Atropine concentrations of at least 0.01% significantly slowed myopia progression over 2 years compared with inactive controls. Greater efficacy was observed at higher doses. These effects were numerically greater than those of optical interventions, although the differences were not statistically significant.
Moderate- to high-dose atropine and repeated low-intensity red-light therapy, either alone or combined with orthokeratology, demonstrated stronger short-term effects but were followed by clinically meaningful rebound 12 months after treatment ended. Low-dose atropine was not associated with clinically meaningful rebound.
Reference
Jovanović J, Zacharioudaki M, Kalatzi M, et al. Low-Dose Atropine and Other Interventions for Pediatric Myopia: A Systematic Review and Bayesian Network Meta-analysis of Efficacy and Post-treatment Outcomes. Ophthalmol Ther. 2026;doi: 10.1007/s40123-026-01478-y. Epub ahead of print. PMID: 42704413.
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