The authors of a study of low-dose atropine to treat myopia in European children said the results favour 0.05% over 0.01% nightly eye-drop use, despite more adverse events in the former group.

Researchers from Centre for Eye Research Ireland and the University of Western Australia’s Centre for Ophthalmology and Visual Science published secondary analysis of the three-year results of the Myopia Outcome Study of Atropine in Children (MOSAIC) study in JAMA Ophthalmology.

Their findings include significant reductions in axial elongation and refractive error progression in children transitioning from placebo to 0.05% atropine in the third year. Notably, those tapering or ceasing 0.01% atropine showed no rebound effects. While 0.05% atropine demonstrated superior efficacy, blurred near vision and photophobia were reported but did not deter adherence. In the group taking placebo then 0.05% atropine, 15% and 8% reported blurred near vision and photophobia, respectively, compared with 3% and 0%, respectively, in the group taking 0.01% atropine then tapering or ceasing atropine. 

The authors said further research is required to explore long-term safety and the role of genetic and environmental factors in myopia progression.