The effectiveness of atropine 0.05% eye drops versus placebo on controlling myopia progression among school children in randomized controlled trials: a systematic review and meta analysis.

BACKGROUND

Particularly in children, atropine eye drops have demonstrated encouraging results in reducing the progression of myopia. Nevertheless, there is insufficient data regarding the single dose atropine 0.05% eye drop’s ability to stop the progression of myopia, despite several studies published in various treatment types and combined comparisons of myopia progression controls. Randomized clinical trial studies measuring spherical equivalent and axial length change outcomes in school-age myopic children without any other health issues that used atropine 0.05% therapy with a placebo control group were eligible for this review.

OBJECTIVE

to synthesize evidence on the effectiveness and safety of atropine 0.05% versus spectacle eye glass to control myopia progression among children with 6 to 12 years of age, 2025.

METHODS

This review followed the PRISMA 2020 guidelines, and JBI SUMARI software was used to carry out the step-by-step procedures from the research topic to data extraction and analysis, including the methodological quality assessment using the JBI critical appraisal check list. The Cochrane GRADEpro evaluation was used to evaluate the degree of certainty in the evidence. The mean difference, inverse I square, and 95% confidence interval were used to express the effect magnitude. The publishing bias was analysed using a funnel plot using STATA 16 software.

RESULTS

A total of 1967 children from eleven studies were included in this study. When compared to a placebo group, atropine 0.05% eye drop has demonstrated a statistically significant decrease in the progression of myopia; the pooled mean SE and AL reduction of myopia progression was − 0.49 dioptres per year (-0.32, -0.57) and 0.18 millimetres per year (0.12, 0.23), respectively. The mean SE reduction with atropine 0.05% eye drop was − 0.41Ds/yr (-0.30, -0.52) in Asian studies and − 0.65Ds/yr (-0.14, -1.16) in non-Asian studies, according to subgroup analysis.

CONCLUSION

Atropine 0.05% eye drops had a significant effect on slowing the progression of myopia over spectacle, given the lack of generalizability and greater heterogeneity across the trials examined in this review. This review has been registered in PROSPERO since 04 November 2024 with registration ID: CRD42024604462.