Myopia progression with atropine and different treatment lenses
Reviewed by Fiona Rowe

This study aimed to determine the effectiveness of low dose atropine at inhibiting myopia progression, the possible additive potency of this treatment combined with either of two peripheral defocus contact lenses over three years of therapy, and whether there was a rebound effect after a one-year washout period. The study included 128 children aged 8–15 years (mean 11.59 ±1.8 years (58% female) with a four-year follow-up after therapy. At baseline, the average myopia was -4.88 ±1.87D. Group A comprised 36 children treated with 0.01% atropine and single vision glasses. Group B comprised 30 children treated with soft peripheral defocus contact lenses and 0.01% atropine. Group C comprised 25 children with dual focus contact lenses and 0.01% atropine. Group D comprised 37 controls wearing single vision glasses. Atropine was given for 18 months and then gradually withdrawn. Total myopia change in spherical equivalent after three years of treatment was -0.83 ±0.27D in group A, -0.56 ±0.32D in group B, -0.48 ±0.18 in group C and -2.77 ±0.76 in group D – a significant increase for group D. After treatment cessation, rebound effect was measured at one year of -0.29 ±0.28D group A, -0.13 ±0.28D group B, -0.09 ±0.18D group C. Atropine with peripheral defocus contact lenses did not have significant additive effect over Atropine with single vision lenses. However, dual focus lenses showed significant advantages in reducing rebound effects over the other two treatment groups. The evidence from this study supports low dose atropine as an effective treatment to decelerate myopia progression over three years and appears most effective in the second and third year of treatment vs during the first year.

Effective decrease in myopia progression with two mechanisms of management.
Erdinest N, Atar-Vardi M, Lavy I, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2024;61(3):204–10.