| Abstract [eng] |
Myopia is the most common ocular disorder among children and adolescents worldwide and, according to the Lithuanian Department of Statistics, it is the second most common in Lithuania. Over the past few decades, the prevalence of myopia has been rapidly increasing, with approximately one-quarter of the global population currently affected. It is estimated that by 2050, every second individual will be myopic. Progressive high myopia is not merely a refractive error but also a significant risk factor for developing other ocular pathologies, including open-angle glaucoma, cataract, myopic macular degeneration, retinal detachment, and myopic choroidal neovascularization. Aim of the study: To evaluate the effects of various concentrations of atropine eye drops (0.01 – 1%) on the control of myopia progression in children, based on the latest scientific literature. Objectives: 1. To review the prevalence, causes, and risk factors of childhood myopia. 2. To compare the safety and efficacy of different atropine concentrations in slowing myopia progression. 3. To identify the optimal atropine concentration for controlling myopia progression in children. 4. To assess the effectiveness of combined myopia control strategies. Research methods: A literature search was conducted using the international database PubMed, the specialized academic search engine Google Scholar, and the research-sharing platform ResearchGate. The following keywords were used: “myopia,” “atropine,” “treatment,” “prevention,” “child,” “axial length,” and “efficacy.” A total of 109 sources published between 2015 and 2025 and 12 older references (published more than 10 years ago) were included. A descriptive analysis was applied to examine the literature. Results: Although 0.5 – 1% atropine eye drops demonstrate high efficacy in slowing myopia progression, their clinical use is limited due to the frequent and pronounced side effects, such as photophobia, accommodative dysfunction, and blurred near vision. Currently, 0.01% atropine is among the most widely used concentrations globally due to its favourable safety profile and moderate efficacy, which has been confirmed in multiple clinical trials. This concentration has been shown to significantly reduce both refractive error progression and axial elongation. However, based on recent studies, the most optimal balance between efficacy and tolerability is observed with the 0.05% atropine concentration. The treatment regimen should be personalized, taking into account the child’s age, risk factors, the rate of myopia progression, and the tolerance of side effects. Conclusions: Myopia is a multifactorial condition influenced by both genetic and environmental factors. Low-dose atropine (0.01 – 0.05%) is the safest option for controlling myopia progression and axial elongation, while high-dose atropine (0.5 – 1%) is the most effective but less tolerated. The 0.05% atropine concentration appears to be the most optimal for achieving a balance between safety and efficacy in managing myopia in children. Combining multiple methods, such as atropine with specially designed spectacles or orthokeratology lenses, have demonstrated superior outcomes compared to atropine monotherapy. Keywords: myopia, atropine, efficacy, children, spectacles, myopia prevention. |
