Efficacy, tolerability, and threshold effect of atropine eye drops for myopia control: A systematic review and dose-response meta-analysis.
Xiu Juan Zhang, Mingming Liu, Marco Yu et al.
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In 30 seconds
This systematic review and dose-response meta-analysis evaluated the efficacy of atropine eye drops for myopia control in 6301 children aged 4-18 years. The study found a nonlinear relationship between atropine dosage and treatment efficacy, with the highest efficacy observed at 1% concentration, reducing annual spherical equivalent refraction progression by 0.99 D (95% CI, 0.66-1.31) compared to placebo. The mean follow-up time was 19.5 months.
Key findings
- Atropine 1% reduced annual spherical equivalent refraction progression by 0.99 D (95% CI, 0.66-1.31) compared to placebo.
- Higher doses of atropine were linked to decreased accommodation amplitude and increased pupil diameters.
- The efficacy of atropine may plateau beyond certain concentrations, suggesting a need for cautious dose adjustments.
Why it matters
Understanding the optimal concentration of atropine for myopia control is crucial for clinicians to effectively manage treatment in pediatric patients, balancing efficacy with potential side effects.
What to keep in mind
The analysis is limited by the heterogeneity in trial design and sample sizes, particularly for higher concentrations, and the lack of pre-intervention refractive history in many studies.