Topical atropine linked to modest rise in IOP during myopia control in children
A new retrospective study suggests that while low-dose atropine remains effective for slowing myopia progression in children, its use may be associated with a slight increase in intraocular pressure (IOP).
Researchers analyzed data from 376 eyes treated with 0.125% atropine compared with an equal number of controls over an average follow-up of nearly 19 months. Baseline IOP levels were similar between groups, but by study end, children receiving atropine had a higher mean IOP (18.3 vs 16.7 mmHg, P < 0.001). Multivariable modeling showed atropine contributed to an additional 0.51 mmHg increase in IOP per year after adjusting for age, sex, refractive error, corneal thickness, and baseline IOP.
Despite this rise, structural measures of the retinal nerve fiber layer and ganglion cell complex thickness remained comparable between atropine users and controls, indicating no apparent short-term impact on optic nerve health.
Researchers concluded that while topical atropine remains a viable option for pediatric myopia control, children receiving long-term therapy should undergo regular IOP monitoring.
Reference
Hsia Y, Chen PJ, Ma IH, et al. Intraocular Pressure Trends in Children with Myopia Receiving Atropine Therapy. Ophthalmol Ther. 2025;doi: 10.1007/s40123-025-01243-7. Epub ahead of print. PMID: 40971063.
