Multimodal imaging evaluation of myopia progression and atropine intervention

Myopia is a refractive disorder primarily characterized by progressive axial elongation. Atropine is widely recognized as one of the most effective interventions for controlling myopia progression. However, existing studies on myopia progression and the mechanisms underlying atropine treatment have predominantly focused on molecular and cellular levels, while imaging-based investigations have largely been limited to single imaging modalities or single-parameter assessments, which are insufficient to characterize the complex fundus alterations associated with myopia. Given that both myopia development and atropine-mediated intervention involve multifactorial and multilevel coordinated changes, there is a pressing need to integrate multiparametric and multimodal imaging strategies to evaluate myopia progression and the effects of atropine intervention. In this study, we established a multiparametric, multimodal fundus imaging framework to longitudinally assess the effects of atropine on myopia progression in a lens-induced myopia (LIM) mouse model. During a 3-week LIM induction period, refractive error (RE) and axial length (AL) were assessed using a combination of optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and fundus fluorescein angiography (FFA) to evaluate retinal thickness (RT) and retinal vascular density (VD). In addition, correlations between axial length and retinal structural and vascular parameters were analyzed to provide an integrated assessment of atropine intervention effects. The results demonstrated that LIM induced significant myopic refractive shifts and axial elongation, accompanied by reductions in retinal thickness and retinal vascular density. Following atropine treatment, these myopia-associated structural and vascular alterations were partially attenuated, with the high-concentration atropine group exhibiting a more pronounced inhibitory effect.