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This study explores the 3-year effectiveness of atropine in a clinical setting.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In this prospective clinical effectiveness study, children with progressive myopia\u2009\u2265\u20091D\/year or myopia\u2009\u2264\u2009\u22122.5D were prescribed atropine 0.5%. Examination, including cycloplegic refraction and axial length (AL), was performed at baseline, and follow-up. Outcome measures were spherical equivalent (SER) and AL; annual progression of SER on treatment was compared with that prior to treatment. Adjustments to the dose were made after 1 year in case of low (AL\u2009\u2265\u20090.3\u2009mm\/year) or high response (AL\u2009&lt;\u20090.1\u2009mm\/year) of AL.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 124 patients were enrolled in the study (median age: 9.5, range: 5\u201316 years). At baseline, median SER was \u22125.03D (interquartile range (IQR): 3.08); median AL was 25.14\u2009mm (IQR: 1.30). <jats:italic>N<\/jats:italic>\u2009=\u200989 (71.8%) children were persistent to therapy throughout the 3-year follow-up. Median annual progression of SER for these children was \u22120.25D (IQR: 0.44); of AL 0.11\u2009mm (IQR: 0.18). Of these, <jats:italic>N<\/jats:italic>\u2009=\u200932 (36.0%) had insufficient response and were assigned to atropine 1%; <jats:italic>N<\/jats:italic>\u2009=\u200926 (29.2%) showed good response and underwent tapering in dose. Rebound of AL progression was not observed. Of the children who ceased therapy, <jats:italic>N<\/jats:italic>\u2009=\u20099 were lost to follow-up; <jats:italic>N<\/jats:italic>\u2009=\u20099 developed an allergic reaction; and <jats:italic>N<\/jats:italic>\u2009=\u200917 (19.1%) stopped due to adverse events.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In children with or at risk of developing high myopia, a starting dose of atropine 0.5% was associated with decreased progression in European children during a 3-year treatment regimen. Our study supports high-dose atropine as a treatment option for children at risk of developing high myopia in adulthood.<\/jats:p>\n<\/jats:sec>","DOI":"10.1038\/s41433-020-1122-7","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T19:08:48Z","timestamp":1600715328000},"page":"2020-2028","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["A 3-year follow-up study of atropine treatment for progressive myopia in Europeans"],"prefix":"10.1038","volume":"34","author":[{"given":"Jan Roelof","family":"Polling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd","family":"Driessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoukje E.","family":"Loudon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoi-Lam","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"van der Schans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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She has received compensation as a consultant for Novartis, Bayer, for Laboratory Thea, Nevakar. JRP has also received compensation as a consultant for Laboratory Thea. ET, SD, SEL, H-LW, AS, and JWLT declare no potential conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}