The effect of 0.01% atropine on ocular axial elongation for myopia children: A protocol for systematic review and meta-analysis

BACKGROUND: Orthokeratology (OK) has a significant effect on the control of myopia progression, and has been accepted by doctors and patients. A small number of studies have shown that the combination of OK and atropine can enhance myopia control. However, owing to individual differences, research groups, drug concentrations, and research design differences, the safety and effectiveness of the combined treatment still need to be verified. Therefore, the present meta-analysis aimed to determine the effect of 0.01% atropine on ocular axial elongation in myopic children. METHODS: We searched the PubMed, Cochrane Library, and CBM databases from inception to March 1, 2022. Meta-analysis will be conducted using STATA version 14.0 and Review Manager version 5.3 softwares. We calculated the weighted mean differences (WMD) to analyze the change in ocular axial length (AL) between orthokeratology combined with 0.01% atropine (OKA) and OK alone. Cochran's Q-statistic and I(2) test were used to evaluate the potential heterogeneity between studies. A sensitivity analysis was performed to evaluate the influence of single studies on the overall estimate. We will also perform subgroup and meta-regression analyses to investigate potential sources of heterogeneity. We will conduct Begger's funnel plots and Egger's linear regression tests to investigate the publication bias. RESULTS: This systematic review aimed to determine the effect of 0.01% atropine on ocular axial elongation in children with myopia. CONCLUSIONS: These findings provide helpful evidence for the effect of 0.01% atropine on ocular axial elongation in myopic children.