Low-dose eyedrops provide no improvement over a placebo for nearsightedness in children.

Low-dose eyedrops provide no improvement over a placebo for nearsightedness in children.

Low-Dose Atropine Eyedrops Not Effective in Slowing Nearsightedness Progression in Children, Study Finds

Eye Exam

Children with nearsightedness, also known as myopia, may not benefit from low doses of atropine eyedrops in slowing the progression of the condition, according to a new clinical trial. The trial delved into the effectiveness of atropine eyedrops at a concentration of 0.01% in children’s myopia treatment. Results showed that this low dosage did not outperform placebo drops in slowing down the progression of myopia or elongation of the eye after two years of treatment.

This finding deviates from the results of other recent trials that suggested a positive effect of low-dose atropine drops in halting myopia. Traditionally, higher concentrations of atropine, ranging from 0.5% to 1%, are utilized by pediatric eye doctors to slow down nearsightedness progression. However, these stronger doses often cause light sensitivity and blurry vision in close range, making the daily administration uncomfortable for children. As a result, researchers aimed to explore if lower concentrations could offer the same benefits while minimizing side effects.

Nearsightedness affects a large number of people worldwide, and the prevalence is expected to rise in the future. By 2030, it is predicted that 39 million people in the United States alone will have myopia. Furthermore, by 2050, this number is estimated to increase to 44 million in the United States and to affect 50% of the global population.

To investigate the effectiveness of low-dose atropine, the clinical trial enrolled 187 children aged between 5 to 12 years, each diagnosed with low or moderate myopia. Among them, 125 children were given low-dose atropine drops, while 62 received placebo drops. After the two-year treatment period, researchers found no significant differences between the two groups in terms of myopia progression or eye structure compared to their initial status. This lack of benefit persisted even six months after the treatment was discontinued.

Dr. Michael Repka, the lead co-author of the study, remarked that previous clinical trials conducted in East Asia demonstrated the benefits of low-dose atropine. However, Repka noted that the absence of treatment benefits in their U.S.-based study may stem from racial differences in atropine response. The study included fewer Asian children, who typically experience faster myopia progression, as well as Black children, whose myopia progresses at a slower rate compared to other races.

Around the age of 16, myopia tends to stabilize in about half of children, and this percentage increases as they grow older. By the early 20s, only about 10% of individuals with myopia will experience continued nearsightedness progression, and by 24 years old, this percentage decreases to 4%.

Dr. Katherine Weise, a co-author of the study, suggests that a different concentration of atropine may be necessary to achieve a beneficial effect in U.S. children. She proposes that combining new pharmaceuticals, special wavelengths of light, and optical strategies like specialized glasses or contact lenses could be explored to reduce myopia progression. Weise also emphasizes the importance of understanding the differences in myopic eyes among different races and ethnicities, highlighting the need for collaboration between vision scientists to develop innovative treatment strategies.

In conclusion, the recent clinical trial demonstrated that low-dose atropine eyedrops at a concentration of 0.01% did not effectively slow down the progression of nearsightedness in children. While previous studies in East Asia have shown positive results, this discrepancy may be attributed to racial differences in myopia response to atropine. Further research is warranted to discover alternative treatment methods or to determine the ideal concentration of atropine for different populations. With a growing number of individuals affected by myopia, there is a pressing need for comprehensive solutions to combat this vision problem.

To learn more about myopia and its management, visit The U.S. National Eye Institute.