Low-concentration atropine eyedrops linked to lower myopia incidence in children

There was a significantly lower incidence of myopia in nonmyopic children aged 4 to 9 years after nightly use of 0.05% atropine eyedrops for 2 years compared with placebo, according to a study published in JAMA.

In the LAMP2 randomized clinical trial, 474 children with myopia with cycloplegic spherical equivalent between +1.00 D to 0.00 D and astigmatism less than −1.00 D were randomized to receive 0.05% atropine (n  =  160), 0.01% atropine (n  =  159), or placebo (n  =  155) eyedrops once nightly in both eyes over 2 years.

The trial was completed by 353 (74.5%) participants.

The 2-year cumulative incidence of myopia was 28.4% (33/116) in those receiving 0.05% atropine, 45.9% (56/122) in those receiving 0.01% atropine, and 53.0% (61/115) in those receiving placebo; compared with the placebo and 0.01% atropine, the 0.05% atropine group had a significantly lower incidence.

Fast myopic shift at 2 years was noted in 25.0%, 45.1%, and 53.9% participants, respectively; compared with the placebo and 0.01% atropine, the 0.05% atropine group had a significantly lower percentage of patients with fast myopic shift.

There was no significant difference in 2-year cumulative myopia incidence or percentage of patients with fast myopic shift between the 0.01% atropine and placebo groups.

The most common adverse event was photophobia which was reported by 12.9%, 18.9%, and 12.2% in the 0.05% atropine, 0.01% atropine, and placebo groups, respectively.

Reference
Yam JC, Zhang XJ, Zhang Y, et al. Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children: The LAMP2 Randomized Clinical Trial. JAMA. 2023;329(6):472-481. doi: 10.1001/jama.2022.24162. PMID: 36786791.