Myopia progression following 0.01% atropine cessation in Australian children: Findings from the Western Australia – Atropine for the Treatment of Myopia (WA‐ATOM) study

• Published in: Clinical & experimental ophthalmology 2024-07, Vol.52 (5), p.507-515
• Main Authors: Lee, Samantha Sze‐Yee, Nilagiri, Vinay Kumar, Lingham, Gareth, Blaszkowska, Magdalena, Sanfilippo, Paul G., Franchina, Maria, Clark, Antony, Mackey, David A.
• Format: Article
• Language: English
• Subjects: Adolescent; Atropine; Atropine - administration & dosage; Australia; axial length; Axial Length, Eye; Child; Disease Progression; Double-Blind Method; Female; Humans; Male; Mydriatics - administration & dosage; Myopia; Myopia - drug therapy; Myopia - physiopathology; myopia control; Ophthalmic Solutions; Placebos; Refraction, Ocular - physiology; Western Australia
• ISSN: 1442-6404; 1442-9071; 1442-9071
• DOI: 10.1111/ceo.14368

Background A rebound in myopia progression following cessation of atropine eyedrops has been reported, yet there is limited data on the effects of stopping 0.01% atropine compared to placebo control. This study tested the hypothesis that there is minimal rebound myopia progression after cessation of 0.01% atropine eyedrops, compared to a placebo. Methods Children with myopia (n = 153) were randomised to receive 0.01% atropine eyedrops or a placebo (2:1 ratio) daily at bedtime during the 2‐year treatment phase of the study. In the third year (wash‐out phase), all participants ceased eyedrop instillation. Participants underwent an eye examination every 6 months, including measurements of spherical equivalent (SphE) after cycloplegia and axial length (AL). Changes in the SphE and AL during the wash‐out phase and throughout the 3 years of the study (treatment + wash‐out phase) were compared between the treatment and control groups. Results During the 1‐year wash‐out phase, SphE and AL progressed by −0.41D (95% CI = −0.33 to −0.22) and +0.20 mm (95% CI = −0.46 to −0.36) in the treatment group compared to −0.28D (95% CI = 0.11 to 0.16) and +0.13 mm (95% CI = 0.18 to 0.21) in the control group. Progression in the treatment group was significantly faster than in the control group (p = 0.016 for SphE and