Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials

Autores
Magurno, Luciano; Lang, Maximiliano; Zapata, Martina; Gallo, Juan Eduardo Maria
Año de publicación
2026
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Low-dose atropine (0.01%) eye drops have emerged as a proposed intervention to slow myopic progression in children, but their short-term efficacy remains uncertain. We conducted a systematic review and meta- analysis of recent randomized, placebo-controlled trials to assess the efficacy and safety of 0.01% atropine in preventing myopia progression.Methods: A comprehensive search of PubMed, Embase, and Cochrane Library (through October 2024) identified double-blind randomized trials published from 2017 to 2024 that compared atropine 0.01% with placebo in children. Primary outcomes were the changes in refractive error (spherical equivalent) and axial length over at least 1 year. Secondary outcomes included treatment- related adverse events (e.g., photophobia). Data were extracted, pooled using random-effects models, and heterogeneity was assessed (I2 statistic).Results: Nine trials (n = 1,091) met inclusion. Spherical equivalent refraction (SER): MD +0.14 D/year (95% CI +0.04 to +0.24, p = 0.01; I2 = 64%). Axial length: MD −0.05 mm/year (95% CI −0.08 to −0.01, p = 0.01; I2 = 30%). Photophobia: RR 1.17 (95% CI 0.43–3.20, p = 0.69; I2 = 15%).Conclusion: At 12 months, 0.01% atropine yields small but statistically significant reductions in the progression of spherical-equivalent refraction and axial elongation, with no statistically significant increase in photophobia versus placebo, although absolute photophobia rates were higher in the atropine group (9.8% vs. 5.9%). Effects are modest and heterogeneous, and the 95% prediction intervals include the null, supporting the need for larger, longer-term trials to define the durability and clinical relevance of these findings.
Fil: Magurno, Luciano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Lang, Maximiliano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Zapata, Martina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Gallo, Juan Eduardo Maria. Universidad Austral. Hospital Universitario Austral. Departamento de Cirugía. Servicio de Oftalmologia.; Argentina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Materia
MYOPIA CONTROL
ATROPINE
AXIAL LENGTH
REFRACTIVE ERRORS
MYOPIA
META-ANALYSIS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/285555
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/285555
network_acronym_str CONICETDig
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network_name_str CONICET Digital (CONICET)
spelling Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trialsMagurno, LucianoLang, MaximilianoZapata, MartinaGallo, Juan Eduardo MariaMYOPIA CONTROLATROPINEAXIAL LENGTHREFRACTIVE ERRORSMYOPIAMETA-ANALYSIShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: Low-dose atropine (0.01%) eye drops have emerged as a proposed intervention to slow myopic progression in children, but their short-term efficacy remains uncertain. We conducted a systematic review and meta- analysis of recent randomized, placebo-controlled trials to assess the efficacy and safety of 0.01% atropine in preventing myopia progression.Methods: A comprehensive search of PubMed, Embase, and Cochrane Library (through October 2024) identified double-blind randomized trials published from 2017 to 2024 that compared atropine 0.01% with placebo in children. Primary outcomes were the changes in refractive error (spherical equivalent) and axial length over at least 1 year. Secondary outcomes included treatment- related adverse events (e.g., photophobia). Data were extracted, pooled using random-effects models, and heterogeneity was assessed (I2 statistic).Results: Nine trials (n = 1,091) met inclusion. Spherical equivalent refraction (SER): MD +0.14 D/year (95% CI +0.04 to +0.24, p = 0.01; I2 = 64%). Axial length: MD −0.05 mm/year (95% CI −0.08 to −0.01, p = 0.01; I2 = 30%). Photophobia: RR 1.17 (95% CI 0.43–3.20, p = 0.69; I2 = 15%).Conclusion: At 12 months, 0.01% atropine yields small but statistically significant reductions in the progression of spherical-equivalent refraction and axial elongation, with no statistically significant increase in photophobia versus placebo, although absolute photophobia rates were higher in the atropine group (9.8% vs. 5.9%). Effects are modest and heterogeneous, and the 95% prediction intervals include the null, supporting the need for larger, longer-term trials to define the durability and clinical relevance of these findings.Fil: Magurno, Luciano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFil: Lang, Maximiliano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFil: Zapata, Martina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFil: Gallo, Juan Eduardo Maria. Universidad Austral. Hospital Universitario Austral. Departamento de Cirugía. Servicio de Oftalmologia.; Argentina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFrontiers Media2026-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/285555Magurno, Luciano; Lang, Maximiliano; Zapata, Martina; Gallo, Juan Eduardo Maria; Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials; Frontiers Media; Frontiers in Medicine; 13; 1-2026; 1-102296-858XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fmed.2026.1715033/fullinfo:eu-repo/semantics/altIdentifier/doi/10.3389/fmed.2026.1715033info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:36:30Zoai:ri.conicet.gov.ar:11336/285555instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:36:30.616CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
title Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
spellingShingle Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
Magurno, Luciano
MYOPIA CONTROL
ATROPINE
AXIAL LENGTH
REFRACTIVE ERRORS
MYOPIA
META-ANALYSIS
title_short Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
title_full Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
title_fullStr Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
title_full_unstemmed Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
title_sort Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials
dc.creator.none.fl_str_mv Magurno, Luciano
Lang, Maximiliano
Zapata, Martina
Gallo, Juan Eduardo Maria
author Magurno, Luciano
author_facet Magurno, Luciano
Lang, Maximiliano
Zapata, Martina
Gallo, Juan Eduardo Maria
author_role author
author2 Lang, Maximiliano
Zapata, Martina
Gallo, Juan Eduardo Maria
author2_role author
author
author
dc.subject.none.fl_str_mv MYOPIA CONTROL
ATROPINE
AXIAL LENGTH
REFRACTIVE ERRORS
MYOPIA
META-ANALYSIS
topic MYOPIA CONTROL
ATROPINE
AXIAL LENGTH
REFRACTIVE ERRORS
MYOPIA
META-ANALYSIS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Low-dose atropine (0.01%) eye drops have emerged as a proposed intervention to slow myopic progression in children, but their short-term efficacy remains uncertain. We conducted a systematic review and meta- analysis of recent randomized, placebo-controlled trials to assess the efficacy and safety of 0.01% atropine in preventing myopia progression.Methods: A comprehensive search of PubMed, Embase, and Cochrane Library (through October 2024) identified double-blind randomized trials published from 2017 to 2024 that compared atropine 0.01% with placebo in children. Primary outcomes were the changes in refractive error (spherical equivalent) and axial length over at least 1 year. Secondary outcomes included treatment- related adverse events (e.g., photophobia). Data were extracted, pooled using random-effects models, and heterogeneity was assessed (I2 statistic).Results: Nine trials (n = 1,091) met inclusion. Spherical equivalent refraction (SER): MD +0.14 D/year (95% CI +0.04 to +0.24, p = 0.01; I2 = 64%). Axial length: MD −0.05 mm/year (95% CI −0.08 to −0.01, p = 0.01; I2 = 30%). Photophobia: RR 1.17 (95% CI 0.43–3.20, p = 0.69; I2 = 15%).Conclusion: At 12 months, 0.01% atropine yields small but statistically significant reductions in the progression of spherical-equivalent refraction and axial elongation, with no statistically significant increase in photophobia versus placebo, although absolute photophobia rates were higher in the atropine group (9.8% vs. 5.9%). Effects are modest and heterogeneous, and the 95% prediction intervals include the null, supporting the need for larger, longer-term trials to define the durability and clinical relevance of these findings.
Fil: Magurno, Luciano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Lang, Maximiliano. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Zapata, Martina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
Fil: Gallo, Juan Eduardo Maria. Universidad Austral. Hospital Universitario Austral. Departamento de Cirugía. Servicio de Oftalmologia.; Argentina. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina
description Background: Low-dose atropine (0.01%) eye drops have emerged as a proposed intervention to slow myopic progression in children, but their short-term efficacy remains uncertain. We conducted a systematic review and meta- analysis of recent randomized, placebo-controlled trials to assess the efficacy and safety of 0.01% atropine in preventing myopia progression.Methods: A comprehensive search of PubMed, Embase, and Cochrane Library (through October 2024) identified double-blind randomized trials published from 2017 to 2024 that compared atropine 0.01% with placebo in children. Primary outcomes were the changes in refractive error (spherical equivalent) and axial length over at least 1 year. Secondary outcomes included treatment- related adverse events (e.g., photophobia). Data were extracted, pooled using random-effects models, and heterogeneity was assessed (I2 statistic).Results: Nine trials (n = 1,091) met inclusion. Spherical equivalent refraction (SER): MD +0.14 D/year (95% CI +0.04 to +0.24, p = 0.01; I2 = 64%). Axial length: MD −0.05 mm/year (95% CI −0.08 to −0.01, p = 0.01; I2 = 30%). Photophobia: RR 1.17 (95% CI 0.43–3.20, p = 0.69; I2 = 15%).Conclusion: At 12 months, 0.01% atropine yields small but statistically significant reductions in the progression of spherical-equivalent refraction and axial elongation, with no statistically significant increase in photophobia versus placebo, although absolute photophobia rates were higher in the atropine group (9.8% vs. 5.9%). Effects are modest and heterogeneous, and the 95% prediction intervals include the null, supporting the need for larger, longer-term trials to define the durability and clinical relevance of these findings.
publishDate 2026
dc.date.none.fl_str_mv 2026-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/285555
Magurno, Luciano; Lang, Maximiliano; Zapata, Martina; Gallo, Juan Eduardo Maria; Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials; Frontiers Media; Frontiers in Medicine; 13; 1-2026; 1-10
2296-858X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/285555
identifier_str_mv Magurno, Luciano; Lang, Maximiliano; Zapata, Martina; Gallo, Juan Eduardo Maria; Low-dose atropine for myopia progression in children: a 2017–2024 systematic review and meta-analysis of randomized placebo-controlled trials; Frontiers Media; Frontiers in Medicine; 13; 1-2026; 1-10
2296-858X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fmed.2026.1715033/full
info:eu-repo/semantics/altIdentifier/doi/10.3389/fmed.2026.1715033
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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