Treatment with low-dose atropine significantly slowed the progression of nearsightedness in children with fewer side effects than higher doses, a study presented at the AAO 2015, the 119th Annual Meeting of the American Academy of Ophthalmology reported.  

Researchers at the Singapore Eye Research Institute and the National Singapore Eye Center presented results from a five-year clinical study showing that drops of low-dose atropine could potentially be an effective treatment in the fight against rapidly worsening eyesight in children with nearsightedness or myopia.

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In 2006, study investigators enrolled and randomized 400 children 6-12 years old to receive nightly doses of atropine drops at concentrations of 0.5%, 0.1%, or 0.01% for 2 years. After 2 years, no atropine was given for 12 months. For children whose eyes became more myopic during the 12 months of no atropine, another round of drops at 0.01% concentration was given for additional 2 years.

Results from the study showed that after 5 years of treatment, children who were given the low-dose 0.01% atropine drops were the least myopic compared to those treated with higher doses. The 0.01% atropine concentration slowed myopia progression by an estimated 50% compared to children not treated with atropine in an earlier study. The low dose also appears to be safe and tolerable in children 6-12 years old for up to 5 years, though further study is needed. Minimal pupil dilation (less than 1 mm) was seen, which minimized light sensitivity experienced at higher concentrations, as well as, minimal near-vision loss.

The use of atropine eye drops for myopia is fairly uncommon in the U.S., most likely due to the several side-effects (eg, pupil dilation, allergic conjunctivitis and dermatitis) associated with it at higher concentrations. Findings from this study could change practice now that lower atropine concentrations showed similar benefit in slowing nearsightedness progression, without the side-effects. Lead investigator and professor of ophthalmology Dr. Donald T. Tan, FRCS, FRCOphth stated, “We now have data showing that it is not only effective, but also safe. Combined with other interventions, this treatment could become a great ally in preventing myopia from causing serious visual impairment in children worldwide.”

However, researchers emphasize that additional study will be needed to establish which children are good candidates, when to safely begin treatment, and the duration of treatment. Additional studies on atropine for myopia progression are expected to be conducted in Europe and Japan.

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