• Fen Fen Li and Jason C Yam.
• Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong.
• Asia Pac J Ophthalmol (Phila). 2019 Sep 1; 8 (5): 360-365.

PurposeAtropine eye drops is an emerging therapy for myopia control. This article reviews the recent clinical trials to provide a better understanding of the use of atropine eye drops on myopia progression.MethodsAll randomized clinical trials of atropine eye drops for myopia progression in the literatures were reviewed.ResultsAtropine eye drops 1% conferred the strongest efficacy on myopia control. However, its use was limited by the side effects of blurred near vision and photophobia. ATOM 2 study evaluated 0.5%, 0.1%, and 0.01% atropine on 400 myopic children, and suggested that 0.01% is the optimal concentration with good efficacy and minimal side effects. Since then, the use of atropine eye drops has been transitioned from high-concentration to low-concentration worldwide. Recent Low-concentration Atropine for Myopia Progression (LAMP) study evaluated 0.05%, 0.025%, 0.01% atropine eye drops and placebo group in 438 myopic children. The study firstly provided placebo-compared evidence of low-concentration atropine eye drops in myopia control. Furthermore, both efficacy and side effects followed a concentration-dependent response within 0.01% to 0.05% atropine. Among them, 0.05% atropine was the optimal concentration to achieve best efficacy and safety profile.ConclusionsLow concentration atropine is effective in myopia control. The widespread use of low-concentration atropine, especially in East Asia, may help prevent the myopia progression for the high-risk children. Further investigations on the rebound phenomenon following drops cessation, and longer-term individualized treatment approach should be warranted.

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