Take-home message: Atropine slowed childhood myopia progression by 50% to 60% in two large trials in Asia.
Reviewed by Donald Tan, MBBS, FRCSE
Singapore—Atropine appears to be an effective treatment for childhood myopia, said Donald Tan, MBBS, FRCSE.
Although myopia in children is a global problem, it is especially prevalent in Asia.
For example, in Singapore, 80% of 18 year olds have myopia, with 13% of them having high myopia, explained Dr. Tan, Arthur Lim Professor in Ophthalmology, ophthalmology and visual sciences academic clinical program, Duke-NUS Graduate Medical School, Singapore National Eye Centre, and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Previous randomized controlled trials that tried to halt myopia progression in children did not find much effect from rigid gas-permeable lenses or progressive addition spectacles, he noted.
However, research at the Singapore Eye Centre has focused on and found success with atropine. Atropine is a nonspecific muscarinic acetylcholine receptor antagonist that is the most effective treatment to inhibit myopia progression to date, Dr. Tan said.
Since the 1970s, atropine 1% eye drops have been used for pupil dilation in inflammatory conditions, accommodative loss in amblyopia therapy, and for myopia control in Asia.
Despite its effectiveness, it is still not completely clear how or why atropine works, Dr. Tan said.
A previous study from Valley Forge Pharmaceuticals tested an atropine gel in children in the United States, but the study was abandoned after the company was acquired by Novartis, Dr. Tan noted. Pediatric trials in the United States often require long-term study, he said.