RT Journal Article
T1 Dose-Dependent Effects of Atropine on Accommodative and Binocular Visual Function for Myopia Control in Children: A Systematic Review and Meta-Analysis
A1 Martínez Pérez, Clara
A1 Santodomingo Rubido, Jacinto
A1 Villa Collar, César
K1 Accommodation
K1 Axial elongation
K1 Binocularity
K1 Binocular vision
K1 Cycloplegia
K1 Refractive progression
AB PURPOSE: To evaluate systematically the effect of different concentrations of atropine eye drops on accommodative amplitude and binocular visual function in children and adolescents with myopia. METHODS: A systematic review and meta-analysis of randomised controlled trials was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (registration number: CRD420261297760). PubMed, Web of Science and Scopus were searched up to January 15, 2025. Eligible studies compared atropine eye drops (0.01–1%) with placebo, single-vision correction or no treatment and reported accommodative or binocular vision outcomes. The primary outcome was the change in accommodative amplitude. Secondary outcomes included accommodative lag, stereoacuity, heterophoria and fusional vergence. Mean differences (MD) with 95% confidence intervals (CI) were pooled using fixed- or random-effects models based on heterogeneity. RESULTS: Thirteen randomised controlled trials were included, most of which were conducted in Asian populations. Low-dose atropine (0.01%) was associated with a small but statistically significant reduction in accommodative amplitude (MD: −0.84 D, 95% CI: −1.50 to −0.18), with substantial heterogeneity and no consistent effects at individual follow-up time points. Intermediate concentrations (0.02–0.03%) showed variable and heterogeneous effects. Atropine 0.05% produced a consistent and clinically meaningful reduction in accommodative amplitude (MD: −1.96D, 95% CI: −2.36 to −1.57) and measurable changes in binocular parameters. Higher concentrations (≥0.1%) resulted in marked cycloplegic effects. CONCLUSIONS: The effects of atropine on accommodation and binocular visual function are dose-dependent. Low-dose atropine demonstrates a favourable functional safety profile, while higher concentrations are associated with clinically relevant accommodative impairment.
PB Springer
SN 0275-5408
YR 2026
FD 2026-05-18
LK https://hdl.handle.net/10347/47245
UL https://hdl.handle.net/10347/47245
LA eng
NO Jacinto Santodomingo-Rubido is a full-time employee of Menicon Co., Ltd. The authors alone are responsible for the content and writing of the paper. Universidade de Santiago de Compostela/CISUG. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.
DS Minerva
RD 25 may 2026