{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:59:32Z","timestamp":1793361572434,"version":"4.5.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2023,2,14]]},"abstract":"\n Importance<\/jats:title>\n Early onset of myopia is associated with high myopia later in life, and myopia is irreversible once developed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the efficacy of low-concentration atropine eyedrops at 0.05% and 0.01% concentration for delaying the onset of myopia.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This randomized, placebo-controlled, double-masked trial conducted at the Chinese University of Hong Kong Eye Centre enrolled 474 nonmyopic children aged 4 through 9 years with cycloplegic spherical equivalent between +1.00 D to 0.00 D and astigmatism less than \u22121.00 D. The first recruited participant started treatment on July 11, 2017, and the last participant was enrolled on June 4, 2020; the date of the final follow-up session was June 4, 2022.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were assigned at random to the 0.05% atropine (n\u2009=\u2009160), 0.01% atropine (n\u2009=\u2009159), and placebo (n\u2009=\u2009155) groups and had eyedrops applied once nightly in both eyes over 2 years.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcomes were the 2-year cumulative incidence rate of myopia (cycloplegic spherical equivalent of at least \u22120.50 D in either eye) and the percentage of participants with fast myopic shift (spherical equivalent myopic shift of at least 1.00 D).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 474 randomized patients (mean age, 6.8 years; 50% female), 353 (74.5%) completed the trial. The 2-year cumulative incidence of myopia in the 0.05% atropine, 0.01% atropine, and placebo groups were 28.4% (33\/116), 45.9% (56\/122), and 53.0% (61\/115), respectively, and the percentages of participants with fast myopic shift at 2 years were 25.0%, 45.1%, and 53.9%. Compared with the placebo group, the 0.05% atropine group had significantly lower 2-year cumulative myopia incidence (difference, 24.6% [95% CI, 12.0%-36.4%]) and percentage of patients with fast myopic shift (difference, 28.9% [95% CI, 16.5%-40.5%]). Compared with the 0.01% atropine group, the 0.05% atropine group had significantly lower 2-year cumulative myopia incidence (difference, 17.5% [95% CI, 5.2%-29.2%]) and percentage of patients with fast myopic shift (difference, 20.1% [95% CI, 8.0%-31.6%]). The 0.01% atropine and placebo groups were not significantly different in 2-year cumulative myopia incidence or percentage of patients with fast myopic shift. Photophobia was the most common adverse event and was reported by 12.9% of participants in the 0.05% atropine group, 18.9% in the 0.01% atropine group, and 12.2% in the placebo group in the second year.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Among children aged 4 to 9 years without myopia, nightly use of 0.05% atropine eyedrops compared with placebo resulted in a significantly lower incidence of myopia and lower percentage of participants with fast myopic shift at 2 years. There was no significant difference between 0.01% atropine and placebo. Further research is needed to replicate the findings, to understand whether this represents a delay or prevention of myopia, and to assess longer-term safety.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n Chinese Clinical Trial Registry:\n ChiCTR-IPR-15006883<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2022.24162","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T11:02:44Z","timestamp":1676372564000},"page":"472","source":"Crossref","is-referenced-by-count":227,"title":["Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children"],"prefix":"10.1001","volume":"329","author":[{"given":"Jason C.","family":"Yam","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong"},{"name":"Hong Kong Eye Hospital, Hong Kong"},{"name":"Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong"},{"name":"Department of Ophthalmology, Hong Kong Children\u2019s Hospital, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu Juan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong"},{"name":"Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin H. 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