{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:58:32Z","timestamp":1793361512383,"version":"4.5.0"},"reference-count":62,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Buddhist Tzu Chi Medical Foundation","award":["TCMF-P 113-07"],"award-info":[{"award-number":["TCMF-P 113-07"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Early-onset myopia increases the risk of irreversible high myopia. Methods: This study systematically evaluated the efficacy and safety of low-dose atropine for myopia control in children with premyopia through meta-analysis using random-effects models. Effect sizes were calculated using risk ratios (RRs) with 95% confidence intervals (CIs). Comprehensive searches of PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov were conducted until 20 December 2023, without language restrictions. Results: Four studies involving 644 children with premyopia aged 4\u201312 years were identified, with atropine concentrations ranging from 0.01% to 0.05%. The analysis focused on myopia incidence and atropine-related adverse events. Lower myopia incidence (RR, 0.62; 95% CI, 0.40\u20130.97 D\/y; p = 0.03) and reduction in rapid myopia shift (\u22650.5 D\/1y) (RR, 0.50; 95% CI, 0.26\u20130.96 D\/y; p &lt; 0.01) were observed in the 12\u201324-month period. Spherical equivalent and axial length exhibited attenuated progression in the atropine group. No major adverse events were detected in either group, whereas the incidence of photophobia and allergic conjunctivitis did not vary in the 12\u201324-month period. Conclusions: Our meta-analysis supports atropine\u2019s efficacy and safety for delaying myopia incidence and controlling progression in children with premyopia. However, further investigation is warranted due to limited studies.<\/jats:p>","DOI":"10.3390\/jcm13051506","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T11:26:59Z","timestamp":1709638019000},"page":"1506","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Efficacy and Safety of Low-Dose Atropine on Myopia Prevention in Premyopic Children: Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Ssu-Hsien","family":"Lee","sequence":"first","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bor-Yuan","family":"Tseng","sequence":"additional","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-9958","authenticated-orcid":false,"given":"Jen-Hung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-5823","authenticated-orcid":false,"given":"Cheng-Jen","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan"},{"name":"Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1038\/519276a","article-title":"The myopia boom","volume":"519","author":"Dolgin","year":"2015","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.ophtha.2017.12.005","article-title":"Progression of Myopic Maculopathy during 18-Year Follow-up","volume":"125","author":"Fang","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/opo.12305","article-title":"Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children","volume":"36","author":"Chua","year":"2016","journal-title":"Ophthalmic Physiol. 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