{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T18:45:58Z","timestamp":1785869158146,"version":"3.56.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Atropine eyedrops have long been used off-label to prevent myopia progression in children, and many clinical trials have been published on this topic in the past 30\u00a0years. Trials initially tested doses ranging from 0.01% to 1%, but more recently, the interest has turned to low doses, mainly 0.01%. Moreover, the first studies were carried out in Asian populations, but the number of trials conducted in other geographical areas has rapidly increased from 2020 onward. This meta-analysis was aimed at summarizing the evidence on the efficacy of 0.01% atropine eyedrops on the reduction of myopia progression, also comparing study findings from different parts of the world.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from PubMed, Scopus and Web of Science databases from 1 January 1 2020 to 31 July 2024. Randomized controlled trials involving children receiving 0.01% atropine eyedrops for at least 1\u00a0year were included. Heterogeneity was quantified by Q, H, and I2 statistics, and a meta-analysis was performed using a random effect model. The risk for bias was assessed using the Cochrane Collaboration (Chapter 6) aspects of bias scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>The primary outcomes were the differences in spherical equivalent refractive errors and axial length at baseline and after 12\u00a0months of treatment with 0.01% atropine eyedrops or placebo. Eleven studies involving 2,046 children (1,172 receiving 0.01% atropine eyedrops and 874 receiving placebo) were included. Atropine was significantly more effective than placebo, with an average reduction of 0.16\/year (95% CI: 0.11\u20130.22) and \u22120.07\/year (95% CI: \u22120.09 to \u22120.05) in spherical equivalent refractive errors and axial length, respectively. The efficacy of 0.01% atropine eyedrops vs. placebo was maintained in a subpopulation of subjects after 24\u00a0months of treatment. We found no difference in atropine efficacy between Southeast Asian populations (1,063 children, 52%) and populations in various other countries (983 children, 48%).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1497667","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:14:10Z","timestamp":1747887250000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["A systematic review with meta-analysis on the efficacy of 0.01% atropine eyedrops in preventing myopia progression in worldwide children\u2019s populations"],"prefix":"10.3389","volume":"16","author":[{"given":"Pierluigi","family":"Navarra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Buzzonetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Amico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melina","family":"Cro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Federico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.ophtha.2011.07.031","article-title":"Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2)","volume":"119","author":"Chia","year":"2012","journal-title":"Ophthalmology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/APO.0000000000000609","article-title":"Atropine ophthalmic solution to Reduce myopia progression in pediatric subjects: the randomized, double-blind multicenter Phase II APPLE study","volume":"12","author":"Chia","year":"2023","journal-title":"Asia Pac J. 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