Effectiveness of 0.01% atropine and orthokeratology for incipient myopia: a 1-year retrospective study

To investigate and compare the effectiveness of 0.01% low-dose atropine (LA) and orthokeratology lenses (OK) monotherapy versus single-vision spectacles (SV) in controlling low myopia in clinical settings. Treatment-naïve Children with a first diagnosis of myopia using single vision spectacles (SV), LA, or OK for at least 1 year were included in this retrospective study. Data from 140 children’s eyes were analyzed at baseline (before the initiation of treatment) and after 1 year of treatment. ANOVA, ANCOVA, and Multiple Liner Regression were undertaken to identify factors significantly associated with axial length (AL) elongation and spherical equivalent refraction (SER) progression over this period. After controlling baseline variates, the adjusted 1-year AL growth of the LA group (0.22 ± 0.54 mm, adjusted p < 0.00) and the OK group (0.30 ± 0.23 mm, adjusted p < 0.00) was slower than that of SV group (0.57 ± 0.41 mm), and there was no statistically significant difference in AL growth between the LA group and the OK group (adjusted p = 0.29). The 1-year SER progression of each treatment group differed significantly (p < 0.00). Specifically, the slowest progression of SER occurred in the group receiving the LA intervention (-0.16 ± 0.38D) compared to the SV group (-0.56 ± 0.42D), followed by the OK group (-0.34 ± 0.34D). Baseline AL (β=-0.299, p < 0.00) and baseline SER (β=-0.255, p < 0.00) were negatively correlated with AL elongation and SER changes, respectively. Age and sex were not significantly associated with AL or SER changes during the study period. After stratification by age, in the subgroup aged 4–7, LA had more significant control effect on AL elongation (p < 0.00) and SER growth (p < 0.00) than SV, while OK only had more significant control effect on AL elongation than SV (P = 0.03). In the subgroup aged 8–12, the control effect of LA and OK on AL elongation and SER growth both became more significant than SV (all P < 0.05). In the early stage of myopia, LA and OK showed similar efficacy in slowing the AL elongation and were significantly better than SV. For the progression of SER, LA had the best control effect, followed by OK.