Abstract
Objectives To explore the rebound effects and safety of atropine on accommodation amplitude in slowing myopia progression. Methods We conducted a meta-analysis to testify proper dosage of atropine in children with myopia. We searched in PubMed, EMBASE, Ovid, and the Cochrane Library up to March 30, 2021. We selected randomised controlled trials (RCTs) that evaluated the efficacy of atropine for controlling myopia progression in children. We performed the inverse variance random-effects model to pool the data using mean difference (MD) for continuous variables. Statistical heterogeneity was assessed using the I2 test. Additionally, we conducted subgroup analyses and sensitivity analyses. Results Seventeen RCTs involving 2955 participants were included. Myopia progression was significantly less in the atropine group than that of the control group, with MD = 0.38 D per year (95% confidence interval, 0.20 to 0.56). Less axial elongation was shown with MD = −0.19 mm per year (95% CI, −0.25 to −0.12). There was a statistically difference among various doses (p=0.00001). In addition, 1.0% atropine showed the rebound effect with MD = −0.54 D per year (95% CI, −0.81 to −0.26) and was more effective in the latter six months than in the former one. Less accommodation amplitude was shown in 0.01% atropine. Conclusion The efficacy of atropine is dose dependent, and 0.01% atropine may be the optimal dose in slowing myopia progression in children with no accommodation dysfunction. A rebound effect is more prominent in high-dose atropine in the former cessation after discontinuation.
Highlights
Myopia, known as nearsightedness, is widely recognized as an urgent public health issue causing significant visual loss for a range of ocular comorbidities including cataract, retinal detachment, and glaucoma [1,2,3]. e high prevalence has been reported to be 80–90% in school children in certain East Asian areas in the past few decades [4,5,6]. e worldwide prevalence of myopia and high myopia is estimated to increase affecting nearly five and one billion people globally, respectively, by the year 2050 [7]. is silent epidemic should not be ignored [8]
Early-onset myopic children are always accompanied with high progression rates and a higher incidence of high myopia [9, 10]
One study demonstrated that atropine caused a reduced myopic progression and rebound effect, which was less pronounced with lower dosage [19]
Summary
Known as nearsightedness, is widely recognized as an urgent public health issue causing significant visual loss for a range of ocular comorbidities including cataract, retinal detachment, and glaucoma [1,2,3]. e high prevalence has been reported to be 80–90% in school children in certain East Asian areas in the past few decades [4,5,6]. e worldwide prevalence of myopia and high myopia is estimated to increase affecting nearly five and one billion people globally, respectively, by the year 2050 [7]. is silent epidemic should not be ignored [8]. Early-onset myopic children are always accompanied with high progression rates and a higher incidence of high myopia [9, 10]. Us, it is instant to prevent myopia promptly. Atropine (low dose, 0.01%; moderate dose, 0.01% to 0.5%; and high dose, 1%) has been used to control myopia progression for many years [13,14,15]. E low-dose atropine has minimal influence on pupil size, loss of accommodation, and near vision for the prevention of myopia progression [14]. 0.05% atropine seemed to be the most effective dosage in myopia prevention [18]. One study demonstrated that atropine caused a reduced myopic progression and rebound effect, which was less pronounced with lower dosage [19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
