Low-Dose Atropine 0.025% for Childhood Myopia Control: A Retrospective Review in Clinical Practice

Aim: In this retrospective audit, Atropine 0.025% eyedrops were evaluated in a clinical setting. Method: Children aged 4–16 years, who were started on Atropine 0.025% with at least 6 months of follow-up, were included. A total of 588 eyes (299 children) were classified as treatment-naïve eyes started on Atropine 0.025% daily (Group A, n146), eyes progressing on Atropine 0.01% daily increased to 0.025% daily (Group B, n287) or combined with myopia control glasses (Group C, n66), and those stable on Atropine 0.01% twice daily converted to Atropine 0.025% daily (Group D, n89). Spherical equivalent (SE) and axial length (AL) were recorded from 6 months before treatment to 24 months after treatment began. Result: Group A children were younger (8.4 ± 1.5 years), while Group D children were older (10.6 ± 1.59 years). Progression in the first 6 m was significantly less than that in 6 m prior in Groups A-C. At 1 year, a change in AL < 0.15 mm was noted in 41%, 49%, 50% and 35%, and a change in AL ≥ 0.30 mm was observed in 38%, 18%, 32% and 23% of eyes in Groups A, B, C and D, respectively. Treatment was increased in 37%, 34%, 12% and 41% of eyes over 2 years in Groups A, B, C and D, respectively. Mean progression at 2 years was −0.63 ± 0.86 D or 0.44 ± 0.31 mm, −0.39 ± 0.59 D or 0.30 ± 0.26 mm, −0.30 ± 0.48 D or 0.36 ± 0.40 mm, and −0.48 ± 0.54 D or 0.33 ± 0.22 mm in Groups A, B, C and D, respectively. Multivariate analysis suggested that progression was mainly associated with younger age. Conclusions: Atropine 0.025% was a useful addition to myopia control, with some eyes requiring further modification in treatment.