Low-dose atropine for high myopia: An observational cohort study

To describe and compare the spherical equivalent progression of pediatric patients with high myopia undergoing treatment with 0.01% atropine and those not receiving any myopia therapy. Retrospective, descriptive cohort study In this IRB-approved study, we analyzed the spherical equivalent (SE) progression in children 6-13 years old treated with 0.01% atropine and those who were not treated for myopia, initial SE of ≤-6 D, astigmatism of ≤2 D, no syndromic conditions, and records of cycloplegic refraction measurements without missing more than one year. Seventy-five eyes were included, with 87% belonging to Hispanic patients. The baseline SE (D) was -7.66±1.40 in the atropine group and -7.90±1.38 in the control group. Over three years, atropine-treated eyes demonstrated slower SE progression compared to controls (P=0.002). Analysis of yearly progression rates (D/year) revealed notably slower progression in the atropine group during the second (P=0.04) and third (P=0.02) years. Our findings suggest that low-dose atropine may be beneficial as a first-line treatment for high myopia due to its favorable safety profile and potential efficacy. Due to limited statistical power, findings should be interpreted cautiously.