Range of unanswered questions may be addressed by ongoing research
This article was reviewed by Donald Tran, MD
An abundance of evidence from randomised, controlled clinical trials supports the use of topical atropine to prevent myopia progression.
Study results also show that using a low dose of atropine minimises adverse effects and myopic rebound after treatment discontinuation. In addition, the findings indicate that the pharmaceutical formulation affects efficacy, said Donald Tan, MD.
Now, research in this area is continuing and is investigating not only the use of atropine for preventing myopia progression, but also whether it can prevent or delay the onset of myopia.
Dr Tan is adjunct professor in ophthalmology, Duke - National University of Singapore Medical School, and Visiting Senior Consultant, Singapore National Eye Centre, Singapore. He previously served as Director of the Singapore Eye Research Institute (SERI) and the Singapore National Eye Centre.
Over a period of two decades, the SERI completed five randomised controlled trials on myopia progression involving approximately 1,900 children, including two studies investigating atropine [ATOM1 (Atropine for the Treatment of Myopia) and ATOM2].
Now, SERI is conducting ATOM3 that is testing atropine as intervention to prevent or delay myopia onset in children.
Discussing atropine treatment as a pharmaceutical strategy for myopia control to address the global myopia burden, Dr Tan said, “A Cochrane systematic review published in 2011 identified over 180 published interventional studies for approaches to reduce myopia progression.
Since then, more than 30 clinical trials on the use of atropine eye drops for myopia control were registered on the clinicaltrials.gov website.”
“These studies tested or are testing atropine in concentrations ranging from 1% to 0.005% in eyedrop, gel and ointment formulations and as standalone treatment or with adjunctive therapies that include orthokeratology, soft bifocal contact lenses, ketorolac, acemanisodiamine and acupuncture. Clearly, this is a fervent area of interest.”