Children with advanced myopia treated with nightly 0.01% atropine experienced slower myopia progression over 12 months than during untreated periods in a randomized crossover pilot trial.
The 24-month open-label study enrolled 19 children with myopia of -4.50 D or greater, who were randomized to receive either 12 months of atropine followed by 12 months of observation or the reverse sequence. During treatment periods, participants used 0.01% atropine eye drops nightly. Researchers assessed changes in spherical equivalent refraction (SER)and axial length (AL) at baseline and every 6 months.
Mean SER progression was -0.75 D/year during atropine treatment versus -1.02 D/year during control periods, resulting in an adjusted treatment effect of +0.26 D/year (P = 0.005). Mean AL elongation was lower during atropine treatment than during control periods (0.34 vs 0.40 mm/year), although the adjusted difference of -0.05 mm/year did not reach statistical significance (P = 0.065).
No significant treatment-by-period interactions were observed for SER or AL, although the investigators noted that the small sample size did not allow rebound effects to be ruled out.
Reference
Tanaka E, Morizane Y, Fujii S, et al. Beyond mild myopia: a pilot randomized trial of 0.01% atropine in school-aged children with myopia ≤ -4.50 D. Jpn J Ophthalmol. 2026;doi: 10.1007/s10384-026-01399-0. Epub ahead of print. PMID: 42479355.
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