Atropine and plus lenses in the control of myopia ‐ results from clinical trials

Abstract

Abstract Purpose A safe and effective treatment that can control or slow the progression of myopia, which typically occurs during childhood, would be a significant advance in the management of myopia. The findings of recent clinical trials evaluating the use of antimuscarinic agents atropine and pirenzepine as well as optical modalities such as progressive addition lenses for controlling the progression of myopia in children are reported. Methods Randomized controlled trials with comparisons of the effectiveness of interventions such as atropine, pirenzepine and progressive addition lenses to decrease myopia progression in myopic children were reviewed. Results Topical atropine was well tolerated and effective in slowing the progression of low and moderate myopia and ocular axial elongation in children. Pirenzepine gel was also effective and relatively safe in slowing myopia progression during a 1‐year treatment period. Progressive addition lenses did not, or at best marginally slowed the increase of myopia and axial elongation. Conclusion Trials of progressive addition lenses on myopia progression have yielded disappointing results. To date, only pharmacological intervention with atropine and pirenzepine appear to have some consistent effect on reducing the progression of myopia. However, the long‐term safety and efficacy profiles of these drugs are not known. As such, well‐designed clinical trials with longer duration of treatment and follow‐up are required.