Relationship of Atropine in Controlling Myopia Progression Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PURPOSE: Myopia is a refractive error where light focuses in front of the retina, causing blurred distance vision. It is linked to complications such as macular degeneration, retinal detachment, glaucoma, and cataracts, potentially resulting in irreversible vision loss. Controlling myopia progression is critical to reduce long-term impairment. This systematic review evaluate and compare different atropine concentrations for slowing myopia progression in pediatric patients.

PATIENTS AND

METHODS

A comprehensive electronic search was conducted in PubMed, Google Scholar, Embase, and the Cochrane Central Register of Controlled Trials for studies published between June 1, 2006, and September 1, 2024. Included studies enrolled participants aged <18 years, used a randomized placebo-controlled design, and evaluated atropine effects on myopia progression in individuals with spherical equivalent ≤ 0.25 D. Primary outcomes, spherical equivalent refractive error (SER) and axial length (AL), were analyzed via meta-analysis using mean differences (MDs) with 95% confidence intervals (CIs).

RESULTS

This meta-analysis included 10 studies (2006-2024) evaluating atropine effects on myopia progression. Atropine significantly slowed progression versus placebo. At 6 and 12 months, MD in SER was 0.26 (95% CI, 0.17-0.34) and 0.54 (95% CI, 0.26-0.82), respectively, (p < 0.001). Atropine also significantly reduced AL growth at 6 months (MD -0.09, 95% CI, -0.14 to -0.04).

CONCLUSION

Atropine effectively reduced AL growth and myopia progression. Heterogeneity across studies suggests variability. Further research is essential to clarify its mechanism.