Myopia control utilizing low-dose atropine as an isolated therapy or in combination with other optical measures: A retrospective cohort study

PURPOSE: To assess the additive potency of low-dose atropine combined with optical measures designed to decrease myopia progression. MATERIALS AND METHODS: This retrospective study included 104 myopic children aged 5–12 over 4 years, divided into five groups: daily instillation of 0.01% atropine and distance single-vision spectacles (A), 0.01% atropine and progressive addition lenses (A + PAL), 0.01% atropine and soft contact lens with peripheral blur (A + CL). Two control groups were included, prescribed bifocal spectacles or single vision (SV) spectacles. Cycloplegic spherical equivalence refraction was measured biannually, including 1 year after cessation of treatment. RESULTS: A significant decrease in myopia progression was noted during the 2(nd) and 3(rd) years of atropine treatment: A −0.55 ± 0.55D, −0.15 ± 0.15, −0.12 ± 0.12D were 1(st), 2(nd), 3(rd) years, respectively, A + PAL −0.47 ± 0.37D, −0.10 ± 0.25D, and −0.11 ± 0.25D were 1(st), 2(nd), 3(rd) years, respectively, A + CL −0.36 ± 0.43D, −0.13 ± 0.29D, and −0.10 ± 0.27D were 1(st), 2(nd), 3(rd) years, respectively. Myopia progression over 3 years, respectively, was −0.82 ± 0.50D, −0.70 ± 0.69D, −0.59 ± 0.66D in the bifocal group and −1.20 ± 1.28D, −0.72 ± 0.62D, −0.65 ± 0.47D in the SV group. One year after cessation of atropine treatment, myopia progression was − 0.32 ± 0.31D in A, −0.23 ± 0.28D in A + PAL, and −0.18 ± 0.35D in A + CL. CONCLUSION: Atropine 0.01% presented as effective at decelerating myopia progression, more prominent in the 2(nd) and 3(rd) years of treatment. Combining atropine 0.01% with optical modalities exhibited a trend for added efficacy over monotherapy. A + CL exhibited the least rebound effect 1 year after cessation of treatment.