Effects of 0.01% atropine on choroidal thickness and retinal microvasculature in myopic caucasian children: one-year prospective study.

PURPOSE: To evaluate the 12-month effects of 0.01% atropine on the choroidal and retinal structure and vasculature in myopic Caucasian children.

METHODS

Sixty-one Caucasian children (122 eyes) aged 6-17 years, with progressive myopia were treated with nightly 0.01% atropine eye drops for one year. Eyes were stratified into low myopia group (SE from -0.50D to -3.00D, inclusive) and moderate myopia group (SE from -6.00D to < -3.00D). Comprehensive ophthalmic examinations, including optical coherence tomography (OCT) and OCT angiography (OCT-A), were performed at baseline, 6 months, and 12 months. Main Outcomes included subfoveal choroidal thickness, macular retinal thickness, macular vessel and perfusion density and foveal avascular zone parameters.

RESULTS

Subfoveal choroidal thickness showed a significant increase in both groups (low myopia: +26.8 μm at 6 months; +20.1 μm at 12 months; moderate myopia: +25.9 μm at 6 months; +39 μm at 12 months. Macular vessel density increased most prominently at 6 months; central vessel density from 8.36 to 9.25 mm⁻¹ (mean difference 0.89 mm⁻¹; 95% CI, 0.51-1.46) and inner area perfusion density from 37.28 to 39.59 mm⁻¹ (mean difference 2.31 mm⁻¹; 95% CI, 1.17-3.76) with results remaining stable at 12 months. Retinal thickness showed a small but statistically significant increase at 12 months, whereas foveal avascular zone parameters showed no significant change.

CONCLUSIONS

In Caucasian myopic children, 0.01% atropine was associated with a moderate subfoveal choroidal thickening and increased macular perfusion without relevant alterations in retinal thickness and with stable foveal avascular zone measurements over 12 months. These structural and vascular changes highlight the need for controlled, long-term studies to clarify their relevance in myopia control.