JAMA Ophthalmol
Higher-dose atropine reduces myopia in children at the cost of minor side effects
Clinical impact: This secondary analysis of the MOSAIC2 trial suggests that 0.05% atropine is more effective in controlling myopia progression, despite mild adverse effects. Efficacy and tolerability should be considered when selecting atropine concentrations for individual patients.
Study details: The MOSAIC2 trial was a double-masked, randomized trial conducted at the Centre for Eye Research Ireland that included 199 children with myopia, aged 6 to 16 years. Participants were divided into two groups: one received nightly placebo for two years followed by 0.05% atropine for one year, and the other received nightly 0.01% atropine for two years followed by rerandomization to placebo, tapering placebo, or tapering of 0.01% atropine for one year.
Results: Children who switched to 0.05% atropine in the third year showed significant reductions in axial elongation and refractive error progression compared with those who tapered or ceased 0.01% atropine. Approximately 20% of the 0.05% atropine group experienced transient blurred near vision or photophobia, but no treatment discontinuations occurred.
Source:
Loughman J, et al. (2025, January 9). JAMA Ophthalmol. Efficacy and Safety of Different Atropine Regimens for the Treatment of Myopia in Children: Three-Year Results of the MOSAIC Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39786755/