Exploring the role of low‐dose atropine in myopia management in children with inherited retinal diseases

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PURPOSE: This study aimed to evaluate the effectiveness of low-dose atropine in slowing myopic progression in children with inherited retinal diseases (IRDs) and myopia. METHODS: Retrospective study of children with IRDs, comparing myopia progression between those who received atropine drops and those who did not was conducted. Annual myopia progression rates were estimated from longitudinal spherical equivalent measurements. Progression was compared between groups using the Mann-Whitney U test and within groups using the Wilcoxon signed-rank test. RESULTS: A total of 27 children (262 refractive examinations) with IRDs and myopia were included (atropine group: 12 children and control group: 15 children). TRPM1 was the most common gene in both groups. Treatment with atropine was initiated at a mean age of 6.4 years. In the atropine group, mean annual myopic progression decreased from -1.01 D/year before treatment to -0.28 D/year after treatment initiation. In the control group, mean annual myopic progression decreased from -0.81 D/year before 6 years of age to -0.45 D/year thereafter. CONCLUSIONS: In children with IRDs, low-dose atropine treatment did not significantly alter myopia progression once age-related effects were accounted for. Early intervention might be required, suggesting the need for future studies exploring earlier treatment and alternative optical strategies for myopia management in this vulnerable pediatric population.

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