Study finds minimal impact of atropine on corneal shape in myopic children

A recent 6-month randomized controlled trial evaluated the effects of two concentrations of atropine on corneal topography in children with myopia.

Of the enrolled 177 children, 92 recieved 1% atropine weekly, and 85 received 0.01% atropine daily. Corneal measurements were taken at baseline, 1 week, 3 months, and 6 months.

Key Findings:

• 1% atropine group:

  • Small hyperopic shift (0.29 D)

  • Slight progression of cylinder refraction (-0.10 D), positively correlated with posterior corneal astigmatism

• 0.01% atropine group:

  • Myopia progression observed (-0.25 D)

  • Cylinder refraction changes were minimal (-0.04 D)

  • Small decrease in anterior keratometry (-0.08 D)

  • Increase in posterior corneal astigmatism (0.04 D)

  • Cylindrical change inversely associated with younger age, spherical refraction, and posterior corneal astigmatism

• Both groups:

  • Posterior corneal asphericity (Q-value) flattened (-0.13 and -0.15)

  • Changes in posterior K1 and K2 positively correlated with Q-value changes

The study indicates that atropine, whether 1% or 0.01%, has minimal influence on corneal topography. Observed changes in corneal shape are largely driven by normal ocular growth and progression of myopia rather than the medication itself.

Reference
Zhao LQ, Ye LY, Chen J, et al. Comparison of the influence of 1% and 0.01% atropine on the corneal topography in myopic children. BMC Ophthalmol. 2025;25(1):650. doi: 10.1186/s12886-025-04465-2. PMID: 41254600; PMCID: PMC12625200.