Efficacy of 0.01% low-dose atropine therapy for the myopia and premyopia in children: a meta-analysis and systematic review

The aim is to systematically analyze the efficacy of 0.01%low-dose atropine therapy for myopia control and prevention in children. All the data were searched from the PubMed, Web of Science, Embase, CNKI and Cochrane Library. The Cochrane Handbook was used to evaluate the quality of the included studies. This meta- analysis was performed with the Revman 5.4 software. Fifteen randomized controlled trials (RCTs) were included in this study with a total of 2527 patients, 1328 in treatment group and 1199 in control group. At a 12 month follow-up, compared with control group, low-dose atropine treatment could reduce the progression in spherical equivalent refractive (SER) for myopia and premyopia children (MD, 0.20; 95%CI,0.13 to 0.27; p < 0.05). Also, less change in axial length (AL) was shown in low-dose atropine group for both myopia and premyopia children (MD, -0.07; 95%CI, -0.09 to -0.06; p < 0.05). At a 24 month follow-up, compared with control group, low-dose atropine treatment could reduce the progression in SER for myopia and premyopia children (MD, 0.31; 95%CI, 0.06 to 0.55; p < 0.05). Less change in AL was shown in low-dose atropine group for myopia children (MD, -0.08; 95%CI, -0.13 to -0.02, p < 0.05) but no significant difference in the premyopia chidren. This meta-analysis shows that 0.01% low-dose atropine therapy could control the refraction progression of myopia children compared with the control group. There was no significant difference between 0.01% atropine and placebo on myopia prevention in the premyopia chidren.