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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1503536

Effectiveness of various atropine concentrations in myopia control for Asian children: a network meta-analysis

Provisionally accepted
Xiaoyan Wang Xiaoyan Wang 1Linyu Zhang Linyu Zhang 2Jinhua Gan Jinhua Gan 3*Yun Wang Yun Wang 4*Weihua Yang Weihua Yang 4*
  • 1 Southwest Medical University, Luzhou, China
  • 2 Eye Hospital of Nanjing Medical University, Nanjing, Liaoning Province, China
  • 3 The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
  • 4 Shenzhen Eye Hospital, Shenzhen, China

The final, formatted version of the article will be published soon.

    Objectives: To assess the effectiveness of various atropine concentrations in managing myopia among children in East, South, and Southeast Asia, and to determine the most effective concentration.Methods: A systematic literature review was conducted using PubMed, Web of Science, Cochrane Library, and EMBASE. The search was limited to articles published up to June 1, 2024, and included studies in Chinese or English. Two researchers independently screened the literature, extracted relevant data, and assessed the data quality using the Revised Cochrane risk-of-bias 2 (RoB2) tool. A network meta-analysis was performed using Stata 14.2 software to compare the efficacy of different atropine concentrations in delaying myopia progression, measured by changes in refraction and axial length.The analysis included 39 studies with 7,712 participants, examining 10 atropine concentrations ranging from 0.005% to 1%. Forest plots indicated that five concentrations (0.01%, 0.02%, 0.025%, 0.05%, and 1%) were more effective than a placebo in controlling myopia progression. The cumulative ordination plot indicated that 0.05% atropine most effectively delayed refraction change, which the mean change per year was 0.62D, while 1% was superior in slowing axial length progression, which the mean change per year was -0.43 mm. Considering both measures, 1% atropine showed the highest efficacy which the mean changes per year were 0.56D in spherical equivalent refraction and -0.43 mm in axial length, followed by 0.05% and 0.125% atropine. Conclusion: While 1% atropine demonstrated the highest efficacy in myopia control among East, South and Southeast Asian children, its use is not recommended due to increased adverse effects and a rapid rebound in myopia after cessation. Considering both efficacy and safety, 0.05% atropine is suggested as the optimal concentration for myopia management in this population.

    Keywords: Atropine, concentration, effectiveness, Myopia, Children, AISA

    Received: 29 Sep 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Wang, Zhang, Gan, Wang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jinhua Gan, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
    Yun Wang, Shenzhen Eye Hospital, Shenzhen, 518040, China
    Weihua Yang, Shenzhen Eye Hospital, Shenzhen, 518040, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.