{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:02:23Z","timestamp":1789621343827,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Atropine and orthokeratology (OK) are used for childhood myopia control, but comparisons of atropine monotherapy, OK monotherapy, and combination therapy remain limited. This study compared 12-month axial length changes and the proportions of fast, intermediate, and slow progressors among these treatments. Methods: This retrospective study included 154 children followed for at least 12 months: 70 received atropine monotherapy, 64 received OK monotherapy, and 20 received combination therapy. Axial length changes at 6 and 12 months were analyzed using a linear mixed-effects model adjusted for age at treatment initiation, sex, baseline axial length and baseline spherical equivalent refractive error. Based on 12-month axial elongation, progression was classified as fast (\u22650.30 mm), intermediate (0.15 to &lt;0.30 mm), or slow (&lt;0.15 mm). Results: At 12 months, mean axial elongation was 0.294 \u00b1 0.209 mm, 0.238 \u00b1 0.228 mm, and 0.160 \u00b1 0.109 mm in the atropine, OK, and combination groups, respectively. The group-by-time interaction was significant (p = 0.006). No significant pairwise differences were observed at 6 months. At 12 months, axial elongation was significantly smaller in the combination group than in the atropine and OK groups (adjusted mean differences, 0.161 and 0.115 mm; 95% CI, 0.078\u20130.245 and 0.024\u20130.207; Holm-adjusted p &lt; 0.001 and 0.027, respectively). There was no significant difference between the atropine and OK groups (p = 0.155). The pattern of progression differed among groups (p = 0.017), with fast progressors least frequent in the combination group (5.0% vs. 32.9% and 32.8%). Conclusions: In this observational cohort, combination therapy was associated with less axial elongation and fewer fast progressors than either monotherapy.<\/jats:p>","DOI":"10.3390\/jcm15187108","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:09:51Z","timestamp":1789387791000},"page":"7108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia"],"prefix":"10.3390","volume":"15","author":[{"given":"Ji Ho","family":"Park","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4739-0048","authenticated-orcid":false,"given":"Chan-Ho","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5271-8982","authenticated-orcid":false,"given":"Jaehan","family":"Joo","sequence":"additional","affiliation":[{"name":"Research Institute of Electronics and Information Communication, College of Information Technology and Convergence, Pukyong National University, Busan 48547, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon Won","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, Inje University Busan Paik Hospital, Inje University, Busan 48547, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-036X","authenticated-orcid":false,"given":"Dongwon","family":"Yi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Hee","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hyo","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6213-3250","authenticated-orcid":false,"given":"Seung Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0313-3928","authenticated-orcid":false,"given":"Sangwoo","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Ye","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"},{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of 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