Purpose: Myopia is a refractive error where light focuses in front of the retina, causing blurred distance vision. It is linked to complications such as macular degeneration, retinal detachment, glaucoma, and cataracts, potentially resulting in irreversible vision loss. Controlling myopia progression is critical to reduce long-term impairment. This systematic review evaluate and compare different atropine concentrations for slowing myopia progression in pediatric patients. Patients and Methods: A comprehensive electronic search was conducted in PubMed, Google Scholar, Embase, and the Cochrane Central Register of Controlled Trials for studies published between June 1, 2006, and September 1, 2024. Included studies enrolled participants aged < 18 years, used a randomized placebo-controlled design, and evaluated atropine effects on myopia progression in individuals with spherical equivalent ≤ 0.25 D. Primary outcomes, spherical equivalent refractive error (SER) and axial length (AL), were analyzed via meta-analysis using mean differences (MDs) with 95% confidence intervals (CIs). Results: This meta-analysis included 10 studies (2006– 2024) evaluating atropine effects on myopia progression. Atropine significantly slowed progression versus placebo. At 6 and 12 months, MD in SER was 0.26 (95% CI, 0.17– 0.34) and 0.54 (95% CI, 0.26– 0.82), respectively, (p < 0.001). Atropine also significantly reduced AL growth at 6 months (MD − 0.09, 95% CI, − 0.14 to − 0.04). Conclusion: Atropine effectively reduced AL growth and myopia progression. Heterogeneity across studies suggests variability. Further research is essential to clarify its mechanism. Plain Language Summary: Myopia, or nearsightedness, is a common eye problem in children that makes distant objects appear blurry. If it worsens quickly, it can lead to serious eye problems later in life, such as retinal damage, glaucoma, or cataracts. Slowing down the progression of myopia is important to protect children’s vision in the long term. This study reviewed and combined results from multiple high-quality clinical trials to find the best dose of atropine eye drops for controlling myopia in children. We looked at how atropine affected vision clarity and eye growth, as well as its side effects. We found that atropine eye drops effectively slowed myopia progression and reduced eye growth. Lower doses were generally safer and caused fewer side effects, while higher doses worked more strongly but sometimes caused blurred near vision or sensitivity to light. These results help doctors and parents make informed decisions about using atropine to protect children’s eyesight. They also highlight the need for more research to understand how atropine works and to identify the safest and most effective dosing strategies. Keywords: low-concentration therapy, refractive error control, photophobia, mydriasis
Almusib et al. (Wed,) studied this question.