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Am J Ophthalmol. 2015 May;159(5):945-9. doi: 10.1016/j.ajo.2015.01.029. Epub 2015 Jan 30.

Risk factors for progressive myopia in the atropine therapy for myopia study.

Author information

Singapore National Eye Center, Singapore.
Singapore Clinical Research Institute, Singapore; Center for Quantitative Medicine, Duke-National University of Singapore Graduate Medical School, Singapore.
Singapore National Eye Center, Singapore; Singapore Eye Research Institute, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Singapore National Eye Center, Singapore; Singapore Eye Research Institute, Singapore. Electronic address:



To investigate variables associated with myopic progression despite treatment in the Atropine in the Treatment of Myopia Study.


Retrospective cohort study.


Two hundred of 400 children were randomized to receive atropine 1% in 1 eye only in this institutional study. Children were followed up with cycloplegic autorefraction every 4 months over 2 years. Children whose myopia progressed by more than 0.5 diopter (D) in the atropine-treated eye at 1 year were classified as being progressors.


Among the 182 children still in the study at 1 year, 22 (12.1%) were classified as progressors. Univariate analysis suggested these children tended to be younger (8.5 ± 1.4 years vs 9.3 ± 1.5 years; P = .023), to have higher myopic spherical equivalent (SE) at baseline (-3.6 ± 1.3 D vs -2.8 ± 1.4 D; P = .015), and to have 2 myopic parents (77.3% vs 48.1%; P = .012). In nonprogressors, the myopia progression at 1 year was less in the atropine-treated eyes compared with the untreated fellow eye (+0.16 ± 0.37 D vs -0.73 ± 0.48 D; P < .001), but in progressors, progression was more similar between eyes (-0.92 ± 0.31 D vs -1.06 ± 0.44 D; P = .363). Regression analysis showed that the risk of being a progressor was 40% lower with each year of increased age, 43% lower for every 1.0 D less in myopia at baseline, and 59% lower for every 1.0 D less in myopic change in the untreated eyes over the first year.


Doctors and parents need to be aware that there is a small group of children (younger, with higher myopia, and greater tendency of myopic progression) who may still progress while receiving atropine treatment.

[Indexed for MEDLINE]

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