Effect of 0.01% atropine eye drops combined with different optical treatments to control low myopia in Chinese children

Purpose: To investigate the efficacy and safety of 0.01% atropine (AT) in combination with different optical treatments for controlling myopia in Chinese children. Methods: This retrospective study analyzed 341 Chinese children aged 6-11 years with myopia between -0.50 D and -3.0 D between January 2022 and May 2023. The fast-progressing, myopic children received three optical treatments combined with 0.01 % atropine: 75 children with single-vision spectacles and atropine (SV + AT), 162 children with defocus-incorporated multi-segment spectacles and atropine (DIMS + AT), or 104 children with orthokeratology and atropine (OK + AT). The changes in spherical equivalent refraction (SER), axial length (AL), intraocular pressure (IOP), and amplitude of accommodation (AMP) were observed at 6-month and 1-year intervals. Results: After controlling for baseline variables, at 6 months, the increase in adjusted AL was significantly greater in the SV + AT group than in the DIMS + AT group (difference = 0.13 mm, 95 % CI: 0.07-0.20, P G 0.05) and in the OK + AT group (difference = 0.09 mm, 95 % CI: 0.09-0.17, P G 0.05). A more significant progression in adjusted SER was also observed in the SV + AT group than in the DIMS group (difference = - 0.20D, 95 % CI: -0.29 to -0.11, P G 0.05). At 12 months, the greatest increase in adjusted AL was observed in the SV + AT group, with a statistically significant difference of 0.24 mm (95 % CI: 0.19-0.29, P G 0.05) compared with the DIMS group and a difference of 0.19 mm (95 % CI: 0.13-0.25, P G 0.05) compared with the OK + ST group. Similarly, a more significant progression in adjusted SER was observed in the SV + AT group than in the DIMS group (difference = -0.36 D, 95 % CI: -0.48 to -0.24, P G 0.05). Conclusions: This study suggested that 0.01% atropine combined with DIMS or orthokeratology may be viable for controlling low myopia in fast-progressing, myopic children.