ReviewOphthalmology and therapy2026
Low-Concentration Atropine for Myopia Management: Recent Evidence and Clinical Implications.
Review in Ophthalmology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Erratum issued
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We conducted a narrative review of peer-reviewed randomized controlled trials (RCTs) investigating low-concentration atropine for myopia management. Studies were identified using the terms "myopia" AND "atropine" and supplemented through reference searches. Key data on spherical equivalent refraction (SER), axial length (AL) progression, participant demographics, and ethnicity were extracted and qualitatively compared across trials. In addition, observed AL progression was contextualized against expected age-matched myopic axial elongation and physiological emmetropic eye growth derived from previously published normative models. Evidence from pivotal trials such as ATOM and LAMP, mainly conducted in Asian populations, demonstrated dose-dependent efficacy of atropine, with 0.05% showing superior outcomes compared with 0.01%. However, more recent studies in non-Asian populations, including STAR, MOSAIC, WA-ATOM, and MTS, have reported more modest treatment effects with 0.01% atropine. Differences in efficacy appear influenced by factors including age, ethnicity, baseline progression rates, environmental exposures, and placebo-group axial elongation rates. The coronavirus disease 2019 (COVID-19) pandemic also impacted outcomes in several trials, highlighting environmental influences on myopia progression. In addition, off-protocol use of myopia-control interventions in studies such as CHAMP further complicates interpretation of atropine efficacy. While low-concentration atropine remains a promising option for myopia management, rebound progression after cessation remains a concern. Emerging evidence suggests that future research should look at higher atropine concentrations, individualized treatment strategies, and comparisons against normative ocular growth trajectories rather than placebo alone. Licensed atropine formulations, particularly within Europe, are anticipated to improve treatment standardization, support regulatory oversight, and help refine future clinical guidelines for myopia management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.