Prevention of Myopia Onset with 0.025% Atropine in Premyopic Children

Purpose: To evaluate the efficacy of 0.025% atropine solution for prevention of myopic shift and myopia onset in premyopic children. Methods: This study was designed as a retrospective cohort study. Six- to 12-year-old children with spherical equivalent refraction of <+1 diopter (D) (defined as premyopia), with cylindrical refraction of <−1 D, without amblyopia, and who received 0.025% atropine eye drops at bedtime every night or no treatment after follow-up for at least 12 months were enrolled. Fast myopic shift is defined as a myopic shift >−0.5 D per year. Results: Fifty children were enrolled in the study. Twenty-four children (average age 7.6 years old) were in the 0.025% atropine group, and 26 children (average age: 8.2 years old) were in the control group. The mean spherical refraction myopic shift in the 0.025% atropine group was −0.14 ± 0.24 D/year, significantly lower than that in the control group, −0.58 ± 0.34 D/year (P < 0.0001). In multiple linear regression analysis, 0.025% atropine treatment was the only independent variable in preventing myopia shift. There were statistically significant differences between the 0.025% atropine group and the control group in myopia onset and fast myopic shift (21% vs. 54%, P = 0.016; 8% vs. 58%, P = 0.0002, respectively). There was no difference between the 2 groups with regard to the symptom of photophobia (16% vs. 8%, P = 0.409). None of the children in either group complained of near-blurred vision. Conclusions: Regular topical administration of 0.025% atropine eye drops can prevent myopia onset and myopic shift in premyopic schoolchildren for a 1-year period.